(Press-News.org) According to the United States Centers for Disease Control and Prevention, over 800,000 Americans die each year from heart disease and stroke. Acute coronary syndrome, which includes heart attack and unstable angina, a condition that can lead to a heart attack, are among the leading causes of death and disability worldwide. In addition to lifestyle changes, medications that lower blood cholesterol are helpful in preventing future cardiac and vascular events, including heart attack and stroke.
New data from a clinical trial led by cardiologists at Brigham and Women's Hospital (BWH) and the Duke Clinical Research Institute indicates that the non-statin, cholesterol-lowering drug ezetimibe, when added to a statin in patients admitted to the hospital with an acute coronary syndrome, demonstrated particular benefit in patients with diabetes. Patients with diabetes who did not receive ezetimibe in the study had a nearly 1 in 2 chance of having a major cardiac event or stroke over the next 7 years. Treatment with ezetimibe reduced the relative risk of having another major cardiac or vascular event by 14 percent when compared to patients who did not receive ezetimibe.
These findings were presented as a clinical trial update at the European Society of Cardiology Congress on August 30, 2015.
"Our study findings represent particularly good news for patients with diabetes who have coronary artery disease," says Robert Giugliano, MD, a senior investigator with the TIMI (Thrombolysis In Myocardial Infarction) Study Group and cardiologist at BWH. "We believe that patients who suffer a heart attack and cannot get to a very low level of LDL-C with a statin should be considered for ezetimibe, particularly if they have diabetes."
In the IMPROVE-IT trial, the largest (18,144 participants) and longest (6 years) study of ezetimibe to date, researchers demonstrated that when ezetimibe was added to statin (simvastatin) therapy, patients experienced a further lowering of LDL-cholesterol by 23-24 percent. Participants who were recruited to the trial had been hospitalized with acute coronary syndrome within the prior 10 days, were not being treated with ezetimibe or the highest dose of potent statins, and had an LDL-cholesterol between 50 and 125 mg/dL. Previous trial findings demonstrated that ezetimibe significantly reduced the relative risk of a future major cardiac or vascular event by 6.4 percent compared to placebo, with no increase in adverse safety events.
In this new analysis, researchers used data from the 27 percent of patients in the IMPROVE-IT trial who had diabetes at the start of the study and found that ezetimibe added to simvastatin reduced LDL-cholesterol by 43 mg/dL after one year compared to 23 mg/dL with simvastatin alone.
According to Dr. Giugliano, "The greater reduction of LDL-cholesterol seen in patients with diabetes who received ezetimibe along with a statin resulted in lower risks of future ischemic (non-bleeding) stroke (by 39 percent), heart attack (by 24 percent), and the composite of death due to cardiovascular causes, including heart attack or stroke (by 20 percent), when compared to patients with diabetes who received statin therapy alone.
Additionally, researchers report that regardless of the presence or absence of diabetes, the benefits of ezetimibe were observed without an increase in rates of liver test abnormalities, muscle side effects, gall-bladder related events, or cancer.
INFORMATION:
This research was supported by Merck & Co, which licenses and develops Zetia (ezetimibe), Zocor (simvastatin), and Vytorin (ezetimibe/simvastatin combination).
Brigham and Women's Hospital (BWH) is a 793-bed nonprofit teaching affiliate of Harvard Medical School and a founding member of Partners HealthCare. BWH has more than 4.2 million annual patient visits, nearly 46,000 inpatient stays and employs nearly 16,000 people. The Brigham's medical preeminence dates back to 1832, and today that rich history in clinical care is coupled with its national leadership in patient care, quality improvement and patient safety initiatives, and its dedication to research, innovation, community engagement and educating and training the next generation of health care professionals. Through investigation and discovery conducted at its Brigham Research Institute (BRI), BWH is an international leader in basic, clinical and translational research on human diseases, more than 1,000 physician-investigators and renowned biomedical scientists and faculty supported by nearly $600 million in funding. For the last 25 years, BWH ranked second in research funding from the National Institutes of Health (NIH) among independent hospitals. BWH continually pushes the boundaries of medicine, including building on its legacy in transplantation by performing a partial face transplant in 2009 and the nation's first full face transplant in 2011. BWH is also home to major landmark epidemiologic population studies, including the Nurses' and Physicians' Health Studies and the Women's Health Initiative as well as the TIMI Study Group, one of the premier cardiovascular clinical trials groups. For more information, resources and to follow us on social media, please visit BWH's online newsroom.
London, UK - 30 Aug 2015: Efforts to improve automated external defibrillator (AED) usage increase bystander defibrillation in public places but not at home, reveals a study of more than 25 000 cardiac arrest patients presented at ESC Congress today by Dr Steen Hansen, a PhD student in the Department of Health, Science and Technology at Aalborg University in Denmark.1 Efforts included increased numbers of AEDs, cardiopulmonary resuscitation (CPR) education and a nationwide AED registry.
"An AED promptly used by a person present at the cardiac arrest site before the emergency ...
London, UK - 30 Aug 2015: Bystander cardiopulmonary resuscitation (CPR) has been linked to a 30% lower risk of nursing home admission and brain damage in survivors of cardiac arrest outside hospital in research presented at ESC Congress today by Dr Kristian Kragholm, a PhD student in the Department of Anesthesiology, Cardiovascular Research Centre, Aalborg University Hospital, Denmark.1
"We know that survival after out-of-hospital cardiac arrest has improved in recent years but until now the degree of disability in survivors was unknown," said Dr Kraghom. "Our study examined ...
London, UK - 30 Aug 2015: Ezetimibe reduces cardiovascular events in patients with diabetes and a recent acute coronary syndrome, according to a subgroup analysis of the IMPROVE-IT trial presented at ESC Congress today by co-principal investigator Dr Robert Giugliano, physician in cardiovascular medicine at Brigham and Women's Hospital in Boston, US.1 Ezetimibe achieved greater reductions in LDL cholesterol than statins alone, resulting in lower risks of cardiovascular events in patients with diabetes. The benefits observed in diabetics were greater than in those without ...
London, UK - 30 Aug 2015: Particulate matter and NO2 air pollution are associated with increased risk of severe heart attacks despite being within European recommended levels, according to research presented at ESC Congress today by Dr Jean-Francois Argacha, a cardiologist at University Hospital Brussels (UZ Brussel-Vrije Universiteit Brussel), in Belgium.1
"Dramatic health consequences of air pollution were first described in Belgium in 1930 after the Meuse Valley fog," said Dr Argacha. "Nowadays, the World Health Organization (WHO) considers air pollution as one of ...
London, UK - 30 Aug 2015: Young adults living in a polluted city show early signs of cardiovascular risk, according to research presented at ESC Congress today by Dr Krzysztof Bryniarski from Jagiellonian University, Collegium Medicum in Krakow, Poland.1 Residing in a polluted city was associated with higher levels of inflammatory markers in otherwise healthy adolescents and young adults, which indicate a greater risk of having a heart attack in future.
Dr Bryniarski said: "This study was conducted by a group of medical students from Jagiellonian University in Krakow, ...
London, UK - 30 Aug 2015: Cold weather is associated with a higher risk of severe heart attack, according to research presented at ESC Congress today by Dr Shuangbo Liu, adult cardiology resident at the University of Manitoba in Winnipeg, Canada.1 The six year study found that each 10°C drop in temperature was associated with a 7% increased risk of ST-elevation myocardial infarction (STEMI), the most severe form of heart attack.
"We studied the effects of temperature on the risk of heart attacks in Winnipeg, Canada, one of the coldest large cities in the world," said ...
London, UK - 30 Aug 2015: Cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest should be conducted for at least 35 minutes, according to research presented at ESC Congress today by Dr Yoshikazu Goto, associate professor and director of the Department of Emergency and Critical Care Medicine at Kanazawa University Hospital in Kanazawa, Japan.1 The study in more than 17 000 patients found that nearly all survivals were achieved within 35 minutes and longer CPR achieved little benefit.
Dr Goto said: "The decision regarding when to stop resuscitation efforts ...
London, UK - 30 Aug 2015: Cold weather is associated with increased risk of ischaemic stroke in patients with atrial fibrillation, according to research presented at ESC Congress today by Dr Tze-Fan Chao, cardiologist at Taipei Veterans General Hospital and the National Yang-Ming University in Taiwan.1 The study in nearly 290 000 patients suggests that cool climate may be an underrated issue for health that deserves more attention.
"Atrial fibrillation (AF) is the most common sustained cardiac arrhythmia and it increases the risk of ischaemic stroke by four- to five-fold," ...
LONDON, UK - In patients with long-standing persistent atrial fibrillation (AF) despite standard treatment, additional electrical isolation of an area called the left atrial appendage (LAA) can improve freedom from AF without increasing complications, results of the BELIEF study show.
The findings were presented today in a Hot Line session at ESC Congress 2015.
"Empirical left atrial appendage isolation, along with the standard approach of pulmonary vein isolation (PVI) and ablation of extra-pulmonary triggers is superior to the standard approach alone in enhancing the ...
LONDON, UK - Adherence to the oral anticoagulant apixaban among patients with atrial fibrillation (AF) was no better for those who received an educational program compared to those who did not, results of the international, randomised AEGEAN trial show.
The results, presented today at ESC Congress 2015, were nevertheless "quite encouraging," according to lead investigator Gilles Montalescot, MD, PhD, from the Institut de Cardiologie, Centre Hospitalier Universitaire Pitié-Salpêtri?re, in Paris, France.
"We used the best possible tools for the educational program, ...
