Comparison of the efficacy and safety of statin and statin/ezetimibe therapy after coronary stent implantation in patients with stable angina

Little is known about the efficacy and safety of intensive lowering of low-density lipoprotein cholesterol (LDL-C) with statin/ezetimibe therapy after coronary stent implantation in patients with stable angina. Fifty patients with stable angina were randomly divided into an atorvastatin (10 mg/day)(A) group and an atorvastatin (10 mg/day)/ezetimibe (10 mg/day) (A + E) group after stent implantation. Follow-up coronary angiography was performed at 6-9 months after stenting. The A and A + E groups showed significant reductions in LDL-C. The levels of LDL-C in the A + E group were significantly lower than those in the A group at follow-up, whereas there were no differences in major adverse cardiac events, in-stent restenosis, or in-stent % diameter stenosis (DS) between the groups. Only the A + E group showed a significant decrease in the levels of highly sensitive C-reactive protein. In a sub-analysis, %DS in the non-target vessel significantly decreased in both groups. Moreover, Delta%DS (Delta = the value at baseline minus that at follow-up) in the A + E group was more closely associated with LDL-C levels at follow-up than that in the A group. There were no significant differences in adverse effects between the A and A + E groups. In conclusion, although statin/ezetimibe therapy was effective and safe for intensive lipid-lowering in patients with stable angina after successful coronary stent implantation, improvement in clinical outcomes with the combination therapy remains unclear. (C) 2012 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.