Ezetimibe Plus Statin Therapy Reduces Apolipoprotein Levels, ASCVD Risk

Atherosclerosis. Cross section of Coronary artery, Human, 4X at 35mm. Has large amount of plaque, & greatly reduced lumen. Large amounts of lipids, calcium, chlolesterol & fibrous connective tissue are deposited in the wall.
In a study presented at ACC 2021, the researchers assessed the cardioprotective effects of ezetimibe and statin combination therapy vs statin up-titration.

The following article is a part of conference coverage from the American College of Cardiology’s 70th Annual Scientific Session & Expo is being held virtually from May 15 to 17, 2021. The team at Cardiology Advisor will be reporting on the latest news and research conducted by clinicians and scientists in the field. Check back for more from the ACC 2021 .

Ezetimibe plus statin therapy significantly decreases levels of apolipoprotein B (Apo-B) and prevents atherosclerosis, thereby reducing atherosclerotic cardiovascular disease (ASCVD) risk, according to research results presented at the American College of Cardiology (ACC) 2021 Annual Meeting, held virtually from May 15 to 17, 2021.

The 2018 ACC/American Heart Association (AHA) guidelines and 2020 European Society of Cardiology/European Atherosclerosis Society (ESC/EAS) guidelines recognize Apo-B as the “most accurate marker representing atherogenic lipoproteins” for predicting ASCVD risk, few studies have compared treatment effects of ezetimibe plus statin therapy to improve apolipoprotein-B levels.

Using a systematic review and meta-analysis, the researchers sought to evaluate the cardioprotective effects of ezetimibe and statin combination therapy compared with statin up-titration for the screening of Apo-B and prevention of atherosclerosis.

In total, the review included 22 studies with a median follow-up of 8 to 12 weeks. Apo-B levels were significantly reduced among patients receiving treatment with ezetimibe plus statins, including atorvastatin, rosuvastatin, simvastatin, pravastatin, and lovastatin, compared with those receiving treatment with high-dose statins (weighted mean difference, -11.05; 95% CI, -12.26 to -9.85; P <.00001).

“Ezetimibe as an adjunct to statin [therapy] significantly decreased Apo-B levels, among which ezetimibe combined with simvastatin had the best therapeutic effect for prevention of atherosclerosis,” the researchers concluded.


Razzack AA, Pothuru S, Robert CA, et al. Cardioprotective effects of ezetimibe as an adjunct to statins versus statin up-titration on apolipoproteins for prevention of atherosclerosis — a systematic review and meta-analysis. Presented at: ACC 2021 Virtual Annual Meeting; May 15-17, 2021. Abstract/Poster 2251-103.

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