The benefit of adding ezetimibe to statin therapy in patients with prior coronary artery bypass graft surgery and acute coronary syndrome in the IMPROVE-IT trial
Authors' conclusion
The clinical benefit of adding ezetimibe to statin appears to be enhanced in patients with prior CABG
Study context
- Population
- Post-ACS patients (mean low density lipoprotein cholesterol (LDL-C) 93.8 mg/dL at presentation), with or without prior CABG1,684 (9.3%) prior CABG
- Participants
- 18,134 patients
- Comparison
- Simvastatin/ezetimibe vs simvastatin/placebo, by prior CABG
- Primary endpoint
- CV death, major coronary event or stroke
- Follow-up
- Median 6 years
Methodological detailssubgroup analysis by prior CABG status
- Subgroup analysis by prior CABG status
Primary result
As reported in the abstract
Primary endpoint, by prior CABG (subgroup)
Absolute risk reduction
8.8%
95% CI 3.1–14.6%
prior CABG
Absolute risk reduction
1.3%
95% CI 0–2.6%
no prior CABG
Further findings
Median time-weighted LDL-C, prior CABG (subgroup) · during the trial
P < 0.001
Median time-weighted LDL-C, no prior CABG (subgroup) · during the trial
P < 0.001
| Outcome | Adj. HR (95% CI) | |
|---|---|---|
| Primary endpoint rate, prior vs no prior CABG | 1.45 (1.33–1.58) | |
| 0.512Adj. HR (log scale) |
- Primary endpoint rate, prior vs no prior CABG: Prior CABG 56%
- Primary endpoint rate, prior vs no prior CABG: No prior CABG 32%
Safety
- No significant between-group differences in safety endpoints
Original publication
The benefit of adding ezetimibe to statin therapy in patients with prior coronary artery bypass graft surgery and acute coronary syndrome in the IMPROVE-IT trial. Eur Heart J. Published 28 August 2016. doi:10.
Summarised from the published abstract; every number is checked against it