TY - JOUR T1 - Changes in LDL-C levels and goal attainment associated with addition of ezetimibe to simvastatin, atorvastatin, or rosuvastatin compared with titrating statin monotherapy. AU - Foody,JoAnne M, AU - Toth,Peter P, AU - Tomassini,Joanne E, AU - Sajjan,Shiva, AU - Ramey,Dena R, AU - Neff,David, AU - Tershakovec,Andrew M, AU - Hu,Henry, AU - Tunceli,Kaan, Y1 - 2013/11/15/ PY - 2013/11/23/entrez PY - 2013/11/23/pubmed PY - 2014/6/18/medline KW - atorvastatin KW - ezetimibe KW - low-density lipoprotein cholesterol goal KW - rosuvastatin SP - 719 EP - 27 JF - Vascular health and risk management JO - Vasc Health Risk Manag VL - 9 N2 - BACKGROUND: Many high-risk coronary heart disease (CHD) patients on statin monotherapy do not achieve guideline-recommended low-density lipoprotein cholesterol (LDL-C) goals, and combination lipid-lowering therapy may be considered for these individuals. The effect of adding ezetimibe to simvastatin, atorvastatin, or rosuvastatin therapy versus titrating these statins on LDL-C changes and goal attainment in CHD or CHD risk-equivalent patients was assessed in a large, managed-care database in the US. METHODS: Eligible patients (n=17,830), initially on statin monotherapy who were ≥18 years with baseline and follow-up LDL-C values, no concomitant use of other lipid-lowering therapy, and on lipid-lowering therapy for ≥42 days, were identified between November 1, 2002 and September 30, 2009. The percent change from baseline in LDL-C levels and the odds ratios for attainment of LDL-C<1.8 and <2.6 mmol/L (70 and 100 mg/dL) were estimated using an analysis of covariance and logistic regression, respectively, adjusted for various baseline factors. RESULTS: LDL-C reductions from baseline and goal attainment improved substantially in patients treated with ezetimibe added onto simvastatin, atorvastatin, or rosuvastatin therapy (n=2,312) versus those (n=13,053) who titrated these statins. In multivariable models, percent change from baseline in LDL-C was -13.1% to -14.8% greater for those who added ezetimibe onto simvastatin, atorvastatin, or rosuvastatin versus those who titrated. The odds of attaining LDL-C<1.8 and <2.6 mmol/L (70 and 100 mg/dL) increased by 2.6-3.2-fold and 2.5-3.1-fold, respectively, in patients who added ezetimibe onto simvastatin, atorvastatin, or rosuvastatin versus titrating statins. CONCLUSION: CHD/CHD risk-equivalent patients in a large US managed-care database, who added ezetimibe onto simvastatin, atorvastatin, or rosuvastatin, had greater LDL-C reductions and goal attainment than those who uptitrated these statin therapies. Our study suggests that high-risk CHD patients in need of more intensive LDL-C lowering therapy may benefit by adding ezetimibe onto statin therapy. SN - 1178-2048 UR - https://www.unboundmedicine.com/medline/citation/24265554/Changes_in_LDL_C_levels_and_goal_attainment_associated_with_addition_of_ezetimibe_to_simvastatin_atorvastatin_or_rosuvastatin_compared_with_titrating_statin_monotherapy_ DB - PRIME DP - Unbound Medicine ER -