A Randomised Controlled Study of High Dose Statin Versus Statin Plus Ezetimibe Therapy in Patients with Acute Coronary Syndrome

Abstract

AIM: To assess the efficacy of statin and ezetimibe combination compared to statin given as monotherapy in maintaining optimum cholesterol level. METHODOLOGY: A Prospective Randomized Interventional study was conducted including 68 patients with ACS with the duration of six months carried out in the Cardiology Department of tertiary care Hospital, Kerala. SPSS 20 version was used to perform the statistical analysis of the collected data. Independent t-test was used to compare quantitative variables between control and case group and paired t-test for comparison of demographic variables. The level of significance was 0.05. RESULTS AND DISCUSSION: Mean LDL-C of control group at baseline was found to be 129.64mg/dL and that of case group was found to be 125.73mg/dL. Mean difference was found to be 3.90. On using Independent t-test, there was no significant difference in LDL-C between the groups with p= 0.664 (t value= 0.437). Mean LDL-C of control group on review was found to be 125.42mg/dL and that of case group was found to be 109.33mg/ dl. Mean difference was found to be 16.09. On using Independent t-test, there was significant difference in LDL-C between the groups with p<0.05 (t value=2.036). CONCLUSION: The LDL-C levels plummets the most in patients who are at highest risk of recurrent coronary event. Therapy using a combination of statin and ezetimibe resulted in remarkable reduction in elevated lipid cholesterol with a similar safety profile compared with doubling of statin dose. Its superior lipid altering efficacy by dual inhibition of cholesterol synthesis and intestinal absorption makes it a drug of choice for ACS.