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Moderate-intensity statin plus ezetimibe vs high-intensity statin according to baseline LDL-C in the treatment of atherosclerotic cardiovascular disease: A post-hoc analysis of the RACING randomized trial
- Title
- Moderate-intensity statin plus ezetimibe vs high-intensity statin according to baseline LDL-C in the treatment of atherosclerotic cardiovascular disease: A post-hoc analysis of the RACING randomized trial
- Authors
- Lee; Bom; Hong; Sung-Jin; Rha; Seung-Woon; Heo; Jung Ho; Hur; Seung-Ho; Choi; Hyun Hee; Kim; Kyung-Jin; Ju Han; Hyun Kuk; Ung; Yu Jeong; Yong-Joon; Seung-Jun; Ahn; Chul-Min; Ko; Young-Guk; Byeong-Keuk; Donghoon; Myeong-Ki; Jang; Yangsoo; Jung-Sun
- Ewha Authors
- 김경진
- SCOPUS Author ID
- 김경진
- Issue Date
- 2023
- Journal Title
- Atherosclerosis
- ISSN
- 0021-9150
- Citation
- Atherosclerosis vol. 386
- Keywords
- Atherosclerosis; Ezetimibe; Hydroxymethylglutaryl-CoA reductase inhibitors
- Publisher
- Elsevier Ireland Ltd
- Indexed
- SCIE; SCOPUS
- Document Type
- Article
- Abstract
- Background and aims: Whether the effect of a combination strategy rather than increasing doses of one drug to lower low-density lipoprotein cholesterol (LDL-C) levels is consistent across baseline LDL-C levels remains uncertain. Methods: In the RACING trial, which showed a non-inferiority of moderate-intensity statin with ezetimibe (rosuvastatin 10 mg with ezetimibe 10 mg) to high-intensity statin (rosuvastatin 20 mg) for the primary outcome (3-year composite of cardiovascular death, major cardiovascular event, or stroke), the heterogeneity in treatment effect according to baseline LDL-C levels was assessed for the primary and secondary outcomes (clinical efficacy and safety). Results: Of 3780 participants, 2817 participants (74.5%) had LDL-C <100 mg/dL, and 963 participants (25.5%) had LDL-C ≥100 mg/dL. The treatment effect of combination therapy versus high-intensity statin monotherapy was similar among the lower LDL-C subset (8.8% vs. 10.2%; hazard ratio [HR] 0.85, 95% confidence interval [CI] 0.67 to 1.08, p = 0.19) and the higher LDL-C subset (10.8% vs. 9.6 %; HR 1.14, 95% CI 0.76 to 1.7, p = 0.53) without a significant interaction (interaction p = 0.22). Of the secondary outcomes, the 1-, 2-, and 3-year achievement of LDL-C <70 mg/dL was greater in the combination therapy group regardless of baseline LDL-C levels. Conclusions: Among ASCVD patients, there was no heterogeneity in the effect of moderate-intensity statin plus ezetimibe combination therapy in the higher and lower baseline LDL-C levels for the 3-year composite of cardiovascular outcomes. © 2023 Elsevier B.V.
- DOI
- 10.1016/j.atherosclerosis.2023.117373
- Appears in Collections:
- 의료원 > 의료원 > Journal papers
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