Intensified lipid lowering using ezetimibe after publication of the IMPROVE-IT trial: A contemporary analysis from the SPUM-ACS cohort.

Gencer, Baris; Carballo, David; Nanchen, David; Koskinas, Konstantinos C.; Klingenberg, Roland; Räber, Lorenz; Auer, Reto; Carballo, Sebastian; Heg, Dik; Windecker, Stephan; Lüscher, Thomas Felix; Matter, Christian M; Rodondi, Nicolas; Mach, François (2020). Intensified lipid lowering using ezetimibe after publication of the IMPROVE-IT trial: A contemporary analysis from the SPUM-ACS cohort. International journal of cardiology, 303, pp. 8-13. Elsevier 10.1016/j.ijcard.2019.12.011

[img] Text
Gencer IntJCardiol 2020.pdf - Published Version
Restricted to registered users only
Available under License Publisher holds Copyright.

Download (352kB) | Request a copy
[img] Text
Gencer IntJCardiol 2019_postprint.pdf - Accepted Version
Restricted to registered users only until 11 December 2020.
Available under License Creative Commons: Attribution-Noncommercial-No Derivative Works (CC-BY-NC-ND).

Download (317kB) | Request a copy
[img] Text
Gencer IntJCardiol 2019_postprint_suppl.pdf - Supplemental Material
Restricted to registered users only until 11 December 2020.
Available under License Creative Commons: Attribution-Noncommercial-No Derivative Works (CC-BY-NC-ND).

Download (375kB) | Request a copy

BACKGROUND The relevance of the IMPROVE-IT trial on real-life practice has not been explored in patients with ACS. METHODS A prospective Swiss cohort of 6266 patients hospitalized for ACS between 2009 and 2017 with a one-year follow-up. The primary endpoints were the ezetimibe use overall or in combination with high-intensity statin at discharge and at one year after ACS. Secondary endpoint was LDL-C target achievement at one year in a subsample of 2984 patients. Relative Ratios (RR) were used to assess changes in primary endpoints before and after the publication of IMPROVE-IT, adjusting for age, sex, diabetes, prior myocardial infarction, LDL-C and attendance to cardiac rehabilitation. RESULTS The period following the publication of the IMPROVE-IT trial was associated with a steady increase in the use of ezetimibe at discharge (from 1.8% to 3.8%, P < 0.001, adjusted RR 2.85, 95% CI 1.90-4.25) and at one year (from 5.0% to 13.8%, P < 0.001, adjusted RR 3.00, 95% CI 2.40-3.75). The combination of high-intensity statin and ezetimibe rose from 0.9% to 2.1% at discharge (P < 0.001, adjusted RR 3.35, 95% CI 1.90-5.89) and from 2.1% to 7.8% at one year (P < 0.001, adjusted RR 3.98, 95% CI 2.90-5.47). The period following the publication of the IMPROVE-IT trial was associated with an improvement of LDL-C target <1.8 mmol/L (adjusted RR 1.37, 95% CI 1.12-1.68). CONCLUSIONS After the publication of the IMPROVE-IT trial, the use of ezetimibe was increased by three-fold in a large contemporary cohort of ACS patients, concomitant with an improved LDL-C target achievement.

Item Type:

Journal Article (Original Article)

Division/Institute:

04 Faculty of Medicine > Pre-clinic Human Medicine > CTU Bern
04 Faculty of Medicine > Department of General Internal Medicine (DAIM) > Clinic of General Internal Medicine > Centre of Competence for General Internal Medicine
04 Faculty of Medicine > Medical Education > Institute of General Practice and Primary Care (BIHAM)
04 Faculty of Medicine > Department of Cardiovascular Disorders (DHGE) > Clinic of Cardiology

UniBE Contributor:

Koskinas, Konstantinos; Räber, Lorenz; Auer, Reto; Heg, Dierik Hans; Windecker, Stephan and Rodondi, Nicolas

Subjects:

600 Technology > 610 Medicine & health
300 Social sciences, sociology & anthropology > 360 Social problems & social services

ISSN:

0167-5273

Publisher:

Elsevier

Funders:

[4] Swiss National Science Foundation

Language:

English

Submitter:

Doris Kopp Heim

Date Deposited:

30 Dec 2019 13:34

Last Modified:

26 Feb 2020 14:10

Publisher DOI:

10.1016/j.ijcard.2019.12.011

PubMed ID:

31859113

Uncontrolled Keywords:

Acute coronary syndromes Ezetimibe Guidelines Lipids Statin

BORIS DOI:

10.7892/boris.137758

URI:

https://boris.unibe.ch/id/eprint/137758

Actions (login required)

Edit item Edit item
Provide Feedback