In:
Journal of Stroke, Korean Stroke Society, Vol. 25, No. 2 ( 2023-05-31), p. 242-250
Abstract:
Background and Purpose Moderate-intensity statin plus ezetimibe versus high-intensity statin alone may provide a greater low-density lipoprotein cholesterol (LDL-C) reduction in patients with recent ischemic stroke.Methods This randomized, open-label, controlled trial assigned patients with recent ischemic stroke 〈 90 days to rosuvastatin/ezetimibe 10/10 mg once daily (ROS10/EZT10) or to rosuvastatin 20 mg once daily (ROS20). The primary endpoint was LDL-C reduction ≥50% from baseline at 90 days. Key secondary endpoints were LDL-C 〈 70 mg/dL and multiple lipid goal achievement, and composite of major vascular events.Results Of 584 randomized, 530 were included in the modified intention-to-treat analysis. The baseline LDL-C level was 130.2±34.7 mg/dL in the ROS10/EZT10 group and 131.0±33.9 mg/dL in the ROS20 group. The primary endpoint was achieved in 198 patients (72.5%) in the ROS10/EZT10 group and 148 (57.6%) in the ROS20 group (odds ratio [95% confidence interval], 1.944 [1.352–2.795] ; 〈 i 〉 P 〈 /i 〉 = 0.0003). LDL-C level 〈 70 mg/dL was achieved in 80.2% and 65.4% in the ROS10/EZT10 and ROS20 groups ( 〈 i 〉 P 〈 /i 〉 =0.0001). Multiple lipid goal achievement rate was 71.1% and 53.7% in the ROS10/EZT10 and ROS20 groups ( 〈 i 〉 P 〈 /i 〉 〈 0.0001). Major vascular events occurred in 1 patient in the ROS10/EZT10 group and 9 in the ROS20 group ( 〈 i 〉 P 〈 /i 〉 =0.0091). The adverse event rates did not differ between the two groups.Conclusion Moderate-intensity rosuvastatin plus ezetimibe was superior to high-intensity rosuvastatin alone for intensive LDL-C reduction in patients with recent ischemic stroke. With the combination therapy, more than 70% of patients achieved LDL-C reduction ≥50% and 80% had an LDL-C 〈 70 mg/dL at 90 days.
Type of Medium:
Online Resource
ISSN:
2287-6391
,
2287-6405
DOI:
10.5853/jos.2022.02957
Language:
English
Publisher:
Korean Stroke Society
Publication Date:
2023
detail.hit.zdb_id:
2814366-8
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