Back to Search
Start Over
Implications for Ezetimibe Therapy Use Based on IMPROVE-IT Criteria.
- Source :
-
American Journal of Medicine . Nov2015, Vol. 128 Issue 11, p1253-1256. 4p. - Publication Year :
- 2015
-
Abstract
- <bold>Purpose: </bold>In the IMProved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT), simvastatin/ezetimibe combination was associated with a 6% relative risk reduction in the combined cardiovascular outcome compared with simvastatin alone in patients with acute coronary syndrome. Given strict inclusion criteria (low-density lipoprotein cholesterol 50-125 mg/dL and no use of statins more potent than simvastatin 40 mg), the implications of this important trial in routine acute coronary syndrome care are unknown.<bold>Methods: </bold>We identified patients with acute coronary syndrome from the Veterans Affairs health care system over a 5-year period and determined what proportion would be candidates for ezetimibe on the basis of IMPROVE-IT criteria. We then evaluated what proportion could potentially see an increase in ezetimibe use if IMPROVE-IT criteria are not strictly followed.<bold>Results: </bold>Of 219,625 patients with acute coronary syndrome, 69,508 (31.6%) would qualify for ezetimibe on the basis of strict criteria. Among those who did not meet IMPROVE-IT criteria (n = 150,117), ezetimibe could potentially be prescribed by clinicians in a further 28% of patients (n = 61,635) using statins more potent than simvastatin 40 mg, 7.1% of patients (15,527) with a documented statin intolerance, and 10.4% of patients (22,758) with low-density lipoprotein cholesterol >125 mg/dL.<bold>Conclusions: </bold>Our results provide a first look at the implications of this trial in a large health care system. Although 31.6% of patients would qualify for ezetimibe, there is a large potential for an increase in ezetimibe use in acute coronary syndrome outside of the strict trial inclusions. These findings call for a discussion on ezetimibe's role in patients with acute coronary syndrome already taking high-intensity statins or those with statin intolerance. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 00029343
- Volume :
- 128
- Issue :
- 11
- Database :
- Academic Search Index
- Journal :
- American Journal of Medicine
- Publication Type :
- Academic Journal
- Accession number :
- 110474286
- Full Text :
- https://doi.org/10.1016/j.amjmed.2015.05.027