Combination cholesterol therapy could save thousands of lives, study suggests

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People who have had a heart attack should immediately be offered a combination of cholesterol lowering drugs with statins and another cholesterol medication, new research suggests.

The study found that people with acute coronary syndrome (ACS) – which includes those who have experienced a heart attack or unstable angina – were 47% less likely to die within three years if they started taking a high dose statin and ezetimibe straight away, compared to just the high dose statin.

The results indicate that out of every 21 patients taking the double treatment for three years, one death was prevented.

Researchers suggest thousands of lives could be changed every year if treatment guidelines are changed to reflect the findings.

This study shows that if we act quickly and decisively to lower patients’ cholesterol with this combination of treatments, we can drastically reduce the risk of death

Professor Maciej Banach

The research was led by Maciej Banach, Professor of Cardiology at the Medical University of Lodz, Poland, and Adjunct Professor at the Ciccarone Centre for the Prevention of Cardiovascular Disease, Johns Hopkins University School of Medicine, USA.

He said: “Patients with acute coronary syndrome, such as those who have already had a heart attack, face a much higher risk of further heart problems.

“Current guidelines, including those on prevention from the European Society of Cardiology, recommend a stepwise approach, first offering a statin only.

“This study shows that if we act quickly and decisively to lower patients’ cholesterol with this combination of treatments, we can drastically reduce the risk of death.

“Around seven million people suffer acute coronary syndrome every year and the majority of cases are linked to high cholesterol and a build-up of fat in the blood vessels.

“We have effective cholesterol lowering treatments, but we must make sure the people who need them are taking them.”

The study included data on 1,536 patients with ACS who were part of the national Polish Registry of Acute Coronary Syndromes (PL-ACS).

Half of them had been treated with a high dose statin only, while the other half were treated with a combination of a high dose statin and ezetimibe, which is used to treat high cholesterol.

According to the findings, published in the Journal of the American Heart Association, those who started taking a statin and ezetimibe straight away were less likely to die of any cause in the following three years.

However, the risk of death was already lower after only 52 days of treatment.

Both statins and ezetimibe are widely available drugs that have been shown to effectively lower the amount of cholesterol in the blood.

When people have high levels of cholesterol it can block their blood vessels increasing the risk of heart disease or stroke.

ACS affects around seven million people worldwide, including around four million heart attack patients.

Researchers say ensuring that all those at risk are started on both treatments straight away could prevent an estimated 330,000 deaths per year.