Comparison of Different Intensive Lipid-Lowering Therapies for Patients with Acute Coronary Syndrome: Ezetimibe and Rosuvastatin Versus High-Dose Rosuvastatin

Introduction: Dyslipidaemias is a risk factor for atherosclerosis that leads to unstable atherosclerotic plaque rupture and acute coronary syndrome. Therefore, it is crucial to find a better control of risk factors to prevent the occurrence of a new acute cardiovascular event. Study aims: We aim to determine whether combining ezetimibe with a high-intensity statin would be a more effective and safer alternative therapy compared to high-intensity statin monotherapy for patients with coronary atherosclerotic heart disease. Materiel and methods: 65 patients were randomly assigned to high-intensity rosuvastatin (group 1) (rosuvastatin 20 mg/d, n = 33), or a combination therapy (group 2) (ezetimibe 10 mg/d and rosuvastatin 10 mg/d, n = 32) with a 3 month of follow-up. A lipid and general blood test to assess effectiveness and safety is done in 3 weeks and 3 months. Informed consent from patients is obtained before they participate in the study. Results: The primary endpoint was the proportion of patients who achieved the LDL-C goal of 55mg/dL in the third month: 60% in the second group vs. 33% in the first group, with a statistically significant difference (p=0.001). It was noted that there was a decrease in high-sensitivity C-reactive protein (Crp) without an increase in blood transaminases. Discussion and conclusion: Statin combined with ezetimibe demonstrates significant benefits in lowering LDL-C and preventing cardiovascular as statin high dose in acute coronary syndromes. Our results are consistent with the literature.