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

  • from Antara Ghosh
  • Clinical Summaries
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • 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.

Limitations

  • Small study population.