Journal article
Comparison of the Effects of Ezetimibe-Statin Combination Therapy on Major Adverse Cardiovascular Events in Patients with and without Diabetes: A Meta-Analysis
Endocrinology and metabolism (Seoul), Vol.33(2), pp.219-227
06/01/2018
DOI: 10.3803/EnM.2018.33.2.219
PMCID: PMC6021322
PMID: 29766679
Abstract
Background: Ezetimibe-statin combination therapy has been found to reduce low density lipoprotein cholesterol levels and the risk of major adverse cardiovascular events (MACEs) in large trials. We sought to examine the differential effect of ezetimibe on MACEs when added to statins according to the presence of diabetes.
Methods: Randomized clinical trials with a sample size of at least 50 participants and at least 24 weeks of follow-up that compared ezetimibe-statin combination therapy with a statin-or placebo-controlled arm and reported at least one MACE, stratified by diabetes status, were included in the meta-analysis and meta-regression.
Results: A total of seven trials with 28,191 enrolled patients (mean age, 63.6 years; 75.1% men; 7,298 with diabetes [25.9%]; mean follow-up, 5 years) were analysed. MACEs stratified by diabetes were obtained from the published data (two trials) or through direct contact (five trials). No significant heterogeneity was observed among studies (I-2=14.7%, P=0.293). Ezetimibe was associated with a greater reduction of MACE risk in subjects with diabetes than in those without diabetes (pooled relative risk, 0.84 vs. 0.93; P-heterogeneity=0.012). In the meta-regression analysis, the presence of diabetes was associated with a greater reduction of MACE risk when ezetimibe was added to statins (beta=0.87, P=0.038).
Conclusion: Ezetimibe-statin combination therapy was associated with greater cardiovascular benefits in patients with diabetes than in those without diabetes. Our findings suggest that ezetimibe-statin combination therapy might be a useful strategy in patients with diabetes at a residual risk of MACEs.
Details
- Title: Subtitle
- Comparison of the Effects of Ezetimibe-Statin Combination Therapy on Major Adverse Cardiovascular Events in Patients with and without Diabetes: A Meta-Analysis
- Creators
- Namki Hong - Yonsei UniversityYong-ho Lee - Yonsei UniversityKenichi Tsujita - Kumamoto UniversityJorge A. Gonzalez - University of Virginia Health SystemChristopher M. Kramer - University of Virginia Health SystemTomas Kovarnik - General University Hospital in PragueGeorge N. Kouvelos - University of IoanninaHiromichi Suzuki - Musashino Tokusyu Hosp, Tokyo, JapanKyungdo Han - Catholic University of KoreaChan Joo Lee - Yonsei UniversitySung Ha Park - Yonsei UniversityByung-Wan Lee - Yonsei UniversityBong-Soo Cha - Yonsei UniversityEun Seok Kang - Yonsei University
- Resource Type
- Journal article
- Publication Details
- Endocrinology and metabolism (Seoul), Vol.33(2), pp.219-227
- Publisher
- Korean Endocrine Soc
- DOI
- 10.3803/EnM.2018.33.2.219
- PMID
- 29766679
- PMCID
- PMC6021322
- ISSN
- 2093-596X
- eISSN
- 2093-5978
- Number of pages
- 9
- Grant note
- Korean Endocrine Society of KES Research Award IGA NT13224-4/2012 / Internal Grant Agency of the Ministry of Health, Czech Republic NRF-2010-013-E0008; NRF-2012000891 / National Research Foundation of Korea - Korean government (MEST, Basic Research Promotion Fund); National Research Foundation of Korea; Ministry of Education, Science & Technology (MEST), Republic of Korea HI14C2476 / Korea Healthcare Technology R&D Project, Ministry of Health and Welfare, Republic of Korea 2016R1A2B4013029 / Bio & Medical Technology Development Program of the NRF, Korea, MSIP; National Research Foundation of Korea
- Language
- English
- Date published
- 06/01/2018
- Academic Unit
- Electrical and Computer Engineering
- Record Identifier
- 9984627338902771
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