Moderate-Intensity Rosuvastatin Plus Ezetimibe Versus High-Intensity Rosuvastatin for Target Low-Density Lipoprotein Cholesterol Goal Achievement in Patients With Recent Ischemic Stroke: A Randomized Controlled Trialopen access
- Authors
- Hong, Keun-Sik; Bang, Oh Young; Park, Jong -Ho; Jung, Jin-Man; Lee, Sang -Hun; Song, Tae-Jin; Nam, Hyo Suk; Park, Hee-Kwon; Jung, Keun-Hwa; Heo, Sung Hyuk; Koo, Jaseong; Yu, Kyung-Ho; Park, Kwang-Yeol; Kim, Chi Kyung; Park, Hong-Kyun; Lee, Jiyoon; Lee, Juneyoung; Seo, Woo-Keun
- Issue Date
- May-2023
- Publisher
- KOREAN STROKE SOC
- Keywords
- Stroke; LDL cholesterol; Rosuvastatin; Ezetimibe; Target goal
- Citation
- JOURNAL OF STROKE, v.25, no.2, pp.242 - 250
- Indexed
- SCIE
SCOPUS
KCI
- Journal Title
- JOURNAL OF STROKE
- Volume
- 25
- Number
- 2
- Start Page
- 242
- End Page
- 250
- URI
- https://scholarworks.bwise.kr/hanyang/handle/2021.sw.hanyang/189621
- DOI
- 10.5853/jos.2022.02957
- ISSN
- 2287-6391
- 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]; P= 0.0003). LDL-C level <70 mg/dL was achieved in 80.2% and 65.4% in the ROS10/EZT10 and ROS20 groups (P=0.0001). Multiple lipid goal achievement rate was 71.1% and 53.7% in the ROS10/EZT10 and ROS20 groups (P<0.0001). Major vascular events occurred in 1 patient in the ROS10/EZT10 group and 9 in the ROS20 group (P=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 reduction ≥50% and 80% had an LDL-C <70 mg/dL at 90 days.
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