Role of Ezetimibe in Lipid-Lowering and Cardiovascular Disease Prevention

With the goal of decreasing low-density cholesterol (LDL-C) to mitigate risk of both primary and secondary cardiovascular outcomes, statins have been the cornerstone of therapy, significantly reducing the incidence of coronary atherosclerotic vascular disease. Previous studies suggest that adding other non-statin LDL-lowering agents may further lower LDL-C without negative side effects. Recent guidelines support the hypothesis that driving the LDL-C level below previously recommended targets may have a beneficial effect. Ezetimibe, a cholesterol absorption blocker that inhibits the Niemann-Pick C1-Like 1 (NPC1L1) receptor, has been the focus of recent trials that support its use in cardiovascular risk reduction. For patients not at goal on statin therapy alone, ezetimibe has proven to be a safe, well-tolerated medication that may be used as an adjunct to statin therapy to further reduce LDL-C, resulting in a significant mortality benefit.