(HealthDay News) — In treatment following acute coronary syndrome (ACS), ezetimibe added to statin therapy appears beneficial, according to a study published in the New England Journal of Medicine.

Christopher P. Cannon, MD, from Brigham and Women’s Hospital in Boston, and colleagues conducted a randomized trial involving 18,144 patients who had been hospitalized for an ACS within the previous 10 days. 

Participants were randomly assigned to simvastatin and ezetimibe or simvastatin and placebo. Patients were followed for a median of 6 years, for a primary endpoint of a composite of cardiovascular (CV) death, nonfatal myocardial infarction (MI), unstable angina requiring rehospitalization, coronary revascularization or nonfatal stroke.

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The researchers found that the median time-weighted average LDL cholesterol level was 53.7 mg/dL and 69.5 mg/dL in the simvastatin-ezetimibe and simvastatin-placebo groups, respectively (P<.001). At 7 years, the Kaplan-Meier event rate for the primary endpoint was 32.7% in the simvastatin-ezetimibe group and 34.7% in the simvastatin-placebo group (HR=0.936; 95% CI, 0.89-0.99; P=.016). 

In the two groups the rates of prespecified muscle, gallbladder and hepatic adverse effects and cancer were similar.

“When added to statin therapy, ezetimibe resulted in incremental lowering of LDL cholesterol levels and improved cardiovascular outcomes,” the researchers wrote.

The study was funded by Merck, which manufactures ezetimibe.


  1. Cannon CP et al. N Engl J Med. 2015;doi:10.1056/NEJMoa1410489.