Addition of Bempedoic Acid to Statin–Ezetimibe versus Statin Titration in Patients with High Cardiovascular Risk: A Single-Centre Prospective Study
Reducing levels of low-density lipoprotein cholesterol (LDL-C) below recommended thresholds is a core component of cardiovascular prevention strategies. We hypothesized that the addition of bempedoic acid to patients already on statin–ezetimibe therapy was more effective than titrating the statin do...
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MDPI AG
2024-09-01
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| Series: | Journal of Cardiovascular Development and Disease |
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| Online Access: | https://www.mdpi.com/2308-3425/11/9/286 |
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| author | Giuseppe Marazzi Giuseppe Caminiti Marco Alfonso Perrone Giuseppe Campolongo Luca Cacciotti Domenico Mario Giamundo Ferdinando Iellamo Paolo Severino Maurizio Volterrani Giuseppe Rosano |
| author_facet | Giuseppe Marazzi Giuseppe Caminiti Marco Alfonso Perrone Giuseppe Campolongo Luca Cacciotti Domenico Mario Giamundo Ferdinando Iellamo Paolo Severino Maurizio Volterrani Giuseppe Rosano |
| author_sort | Giuseppe Marazzi |
| collection | DOAJ |
| description | Reducing levels of low-density lipoprotein cholesterol (LDL-C) below recommended thresholds is a core component of cardiovascular prevention strategies. We hypothesized that the addition of bempedoic acid to patients already on statin–ezetimibe therapy was more effective than titrating the statin dose in reducing LDL-C. The study enrolled 120 patients at high cardiovascular risk and with LDL-C above 70 mg/dL. They were randomly divided into two groups: the bempedoic acid (BA) group, taking bempedoic acid in addition to statin plus ezitimibe, and the statin titration (ST) group, including patients who doubled the dose of statin. At 12 weeks, the BA group presented a more significant decrease in LDL-C compared to the ST group (−22.9% vs. 7.5% <i>p</i> 0.002). The total cholesterol decreased significantly in the BA group compared to ST (−14.8% vs.−4.7%; <i>p</i> 0.013) No significant between-group changes in HDL and triglycerides occurred. At 12 weeks, the number of patients who reached LDL-C lower than 70 mg/dL was 38 (63%) in the BA group versus 22 (37%) in the ST group (between groups, <i>p</i> 0.034). In the BA group, the LDL-lowering effect of bempedoic acid was similar between patients taking atorvastatin and rosuvastatin. No side effects occurred during the follow up period. In conclusion, the addition of bempedoic acid to statin–ezetimibe combined treatment was more effective than doubling the dose of statin in reducing LDL-C levels and increased the number of patients reaching the LDL-C goal. |
| format | Article |
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| institution | OA Journals |
| issn | 2308-3425 |
| language | English |
| publishDate | 2024-09-01 |
| publisher | MDPI AG |
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| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj-art-d31c634942e44c328fc92abca84aebb12025-08-20T01:55:34ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252024-09-0111928610.3390/jcdd11090286Addition of Bempedoic Acid to Statin–Ezetimibe versus Statin Titration in Patients with High Cardiovascular Risk: A Single-Centre Prospective StudyGiuseppe Marazzi0Giuseppe Caminiti1Marco Alfonso Perrone2Giuseppe Campolongo3Luca Cacciotti4Domenico Mario Giamundo5Ferdinando Iellamo6Paolo Severino7Maurizio Volterrani8Giuseppe Rosano9Cardiology Rehabilitation Unit, Istituto di Ricovero e Cura a Carattere Scinrifico ì San Raffaele, 00163 Rome, ItalyCardiology Rehabilitation Unit, Istituto di Ricovero e Cura a Carattere Scinrifico ì San Raffaele, 00163 Rome, ItalyDivision of Cardiology and Sports Medicine, Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, ItalyDepartment of Cardiac Surgery, S. Carlo di Nancy Hospital, 00165 Rome, ItalyCardiology Unit, Madre Giuseppina Vannini Hospital, 00177 Rome, ItalyDepartment of Systems Medicine, Tor Vergata University, 00133 Rome, ItalyDivision of Cardiology and Sports Medicine, Department of Clinical Sciences and Translational Medicine, University of Rome Tor Vergata, 00133 Rome, ItalyDepartment of Clinical Internal Anesthesiology and Cardiovascular Sciences, Sapienza University of Rome, 00163 Rome, ItalyCardiology Rehabilitation Unit, Istituto di Ricovero e Cura a Carattere Scinrifico ì San Raffaele, 00163 Rome, ItalyDepartment of Cardiology, St George’s University, St George’s University Hospitals, London SW17 0QT, UKReducing levels of low-density lipoprotein cholesterol (LDL-C) below recommended thresholds is a core component of cardiovascular prevention strategies. We hypothesized that the addition of bempedoic acid to patients already on statin–ezetimibe therapy was more effective than titrating the statin dose in reducing LDL-C. The study enrolled 120 patients at high cardiovascular risk and with LDL-C above 70 mg/dL. They were randomly divided into two groups: the bempedoic acid (BA) group, taking bempedoic acid in addition to statin plus ezitimibe, and the statin titration (ST) group, including patients who doubled the dose of statin. At 12 weeks, the BA group presented a more significant decrease in LDL-C compared to the ST group (−22.9% vs. 7.5% <i>p</i> 0.002). The total cholesterol decreased significantly in the BA group compared to ST (−14.8% vs.−4.7%; <i>p</i> 0.013) No significant between-group changes in HDL and triglycerides occurred. At 12 weeks, the number of patients who reached LDL-C lower than 70 mg/dL was 38 (63%) in the BA group versus 22 (37%) in the ST group (between groups, <i>p</i> 0.034). In the BA group, the LDL-lowering effect of bempedoic acid was similar between patients taking atorvastatin and rosuvastatin. No side effects occurred during the follow up period. In conclusion, the addition of bempedoic acid to statin–ezetimibe combined treatment was more effective than doubling the dose of statin in reducing LDL-C levels and increased the number of patients reaching the LDL-C goal.https://www.mdpi.com/2308-3425/11/9/286bempedoic acidhypercolesterolemiaprimary preventionstatinsezetimibe |
| spellingShingle | Giuseppe Marazzi Giuseppe Caminiti Marco Alfonso Perrone Giuseppe Campolongo Luca Cacciotti Domenico Mario Giamundo Ferdinando Iellamo Paolo Severino Maurizio Volterrani Giuseppe Rosano Addition of Bempedoic Acid to Statin–Ezetimibe versus Statin Titration in Patients with High Cardiovascular Risk: A Single-Centre Prospective Study Journal of Cardiovascular Development and Disease bempedoic acid hypercolesterolemia primary prevention statins ezetimibe |
| title | Addition of Bempedoic Acid to Statin–Ezetimibe versus Statin Titration in Patients with High Cardiovascular Risk: A Single-Centre Prospective Study |
| title_full | Addition of Bempedoic Acid to Statin–Ezetimibe versus Statin Titration in Patients with High Cardiovascular Risk: A Single-Centre Prospective Study |
| title_fullStr | Addition of Bempedoic Acid to Statin–Ezetimibe versus Statin Titration in Patients with High Cardiovascular Risk: A Single-Centre Prospective Study |
| title_full_unstemmed | Addition of Bempedoic Acid to Statin–Ezetimibe versus Statin Titration in Patients with High Cardiovascular Risk: A Single-Centre Prospective Study |
| title_short | Addition of Bempedoic Acid to Statin–Ezetimibe versus Statin Titration in Patients with High Cardiovascular Risk: A Single-Centre Prospective Study |
| title_sort | addition of bempedoic acid to statin ezetimibe versus statin titration in patients with high cardiovascular risk a single centre prospective study |
| topic | bempedoic acid hypercolesterolemia primary prevention statins ezetimibe |
| url | https://www.mdpi.com/2308-3425/11/9/286 |
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