Pitavastatin Plus Ezetimibe May Improve Outcomes for ACS Without Hypertension

Combined treatment with pitavastatin and ezetimibe may be beneficial in patients with acute coronary syndrome and without hypertension for secondary prevention.

The following article is part of conference coverage from the 2018 AHA Scientific Sessions in Chicago, Illinois.The Cardiology Advisor’s staff will be reporting breaking news associated with research conducted by leading experts in cardiology. Check back for the latest news from AHA 2018.

CHICAGO — Risk factors may vary in patients with acute coronary syndrome (ACS), both with and without secondary hypertension, and joint therapies with pitavastatin and ezetimibe may be useful as a secondary deterrence for patients with ACS who do not have hypertension, according to research presented at the Scientific Sessions of the American Heart Association, held November 10-12, 2018.

Researchers used Kaplan-Meier analysis and multivariate Cox regression analysis to evaluate risk factors for major adverse cardiac events (MACEs) that included age, sex, previous myocardial infarction, smoking history, and diabetes. The goal was to uncover MACE predictors in individuals with ACS who also had dyslipidemia and were undergoing hard line lipid-lowering therapy on the basis of whether they had received a hypertension diagnosis.

In patients with hypertension, Cox regression analysis revealed 3 of the factors to be autonomous predictors of MACEs: age (hazard ratio [HR] 1.01, P <.05), diabetes (HR 1.33, P <.01), and smoking (HR 1.34, P <.01). 

In patients without hypertension, 4 of the factors were autonomous predictors of MACEs: age (HR 1.03, P <.001), diabetes (HR 1.63, <.01), smoking (HR 1.42, P <.05), and previous myocardial infarction (HR 2.15, P <.01). Only the pooled use of pitavastatin and ezetimibe (HR 0.63, P <.01) lowered MACEs risk.

Kaplan-Meier analysis showed that joint therapy with pitavastatin and ezetimibe lowered the rate of MACEs more effectively than pitavastatin monotreatment in non-hypertension patients only.

Researchers concluded that “risk factors differed between ACS patients with and without hypertension. Moreover, combined treatment with pitavastatin and ezetimibe may be beneficial in ACS patients without hypertension for secondary prevention.”

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Sekiguchi H, Suzuki K, Im J, et al. Effect of combination therapy with ezetimibe and pitavastatin on cardiovascular outcomes in patients with and without hypertension: findings of the HIJ-PROPER trial. Presented at: AHA 2018; November 10-12, 2018; Chicago, Illinois. Abstract Sa2093/2093.