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Have We Learnt all from IMPROVE-IT? Part II. Subanalyses of the Effects of Ezetimibe Added to Statin Therapy on Selected Clinical and Laboratory Outcomes, Cost-Effectiveness, Guidelines, and Clinical Implications

[ Vol. 19 , Issue. 5 ]


Zlatko Fras* and Dimitri P. Mikhailidis   Pages 469 - 486 ( 18 )


In this second part of the review of the IMProved Reduction of Outcomes: Vytorin Efficacy International Trial (IMPROVE-IT), the findings in relation to patients with stroke, the ACS phenotype, history of coronary artery bypass graft surgery, heart failure, concurrent polyvascular atherosclerotic cardiovascular disease (ASCVD) and diabetes mellitus, and different levels of expression of selected cardiovascular biomarkers, are discussed. The combination therapy was proven safe, and drug discontinuation rates were not increased by adding ezetimibe. Since both statins and ezetimibe are now almost globally generically available, it can be concluded that for secondary prevention of ASCVD, adding ezetimibe to high-intensity statin therapy further reduces low-density lipoprotein cholesterol (LDL-C) and cardiovascular risk, cost-effectively.


IMPROVE-IT trial, ezetimibe, statin, combination lipid-lowering drug therapy, secondary prevention, costeffectiveness, safety, lipid-lowering guidelines.


Centre for Preventive Cardiology, Department of Vascular Medicine, Division of Medicine, University Medical Centre, Ljubljana, Department of Clinical Biochemistry, Royal Free Hospital Campus, University College Medical School, University College London, London

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