Coronary artery disease: low-dose statin+ezetimibe and/or nutraceuticals effective and safe in high-dose statin-intolerant patients

  • Marazzi G & al.
  • Am J Cardiol
  • 19 Oct 2018

  • curated by Antara Ghosh
  • UK Clinical Digest
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  • Patients with coronary artery disease who were high-dose statin intolerant, dual combination therapy with low-dose statin (LDS) and either ezetimibe or nutraceuticals is a reliable, effective and a safe treatment option.

Why this matters

  • European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines for dyslipidaemia management recommend use of nutraceuticals as an alternative or additional lipid-lowering drug.

Study design

  • TACO evaluated 100 high-dose statin-intolerant patients with coronary artery disease who underwent percutaneous coronary intervention in the preceding 12 months and were not at low-density lipoprotein cholesterol (LDL-C) target (
  • Patients were randomly allocated to receive either LDS+ezetimibe or LDS+nutraceuticals (Armolipid Plus containing red yeast rice, policosanol, and berberine [Armolipid+]) for 3 months.
  • Patients not achieving therapeutic goal received triple combination therapy of LDS+ezetimibe+Armolipid+ for further 3 months.
  • Funding: Italian Ministry of Education.

Key results

  • 66% vs 62% patients who received LDS+ezetimibe and LDS+Armolipid+, respectively, achieved LDL-C therapeutic target at 3 months and maintained it at 6 months.
  • Reduction in LDL-C concentration at 3 months was higher in LDS+Armolipid+ (–26 mg/dL) vs LDS+ezetimibe (–16 mg/dL) group (P<.00001>
  • Reduction in total cholesterol was significantly greater in LDS+Armolipid+ vs LDS+ezetimibe group (P=.0005).
  • 78% of patients receiving triple therapy achieved therapeutic target.
  • None of the patients experienced major side effects.


  • Small study population.

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