Effects of ezetimibe combined with atorvastatin therapy on clinical efficacy and major adverse cardiovascular events in patients with acute coronary syndrome

YANG Ru-ping

doi:10.3969/j.issn.1009-8933.2025.04.007

Abstract：Background: Acute coronary syndrome (ACS) is a cardiovascular emergency, and patients continue to face a considerable long-term risk of major adverse cardiovascular events (MACE) even after receiving standard treatment. Intensive lipid-lowering therapy is central to the secondary prevention of ACS; however, some patients fail to achieve lipid targets or are intolerant to statin monotherapy. A dual lipid-lowering strategy combining ezetimibe with statins has demonstrated advantages in the management of various dyslipidemias, yet its clinical efficacy and impact on long-term cardiovascular outcomes in ACS patients require further substantiation. Methods: A total of 60 ACS patients treated at our hospital from June 2023 to November 2024 were enrolled in this study. They were randomly assigned using a random number table method into two groups: the observation group (n=30, receiving ezetimibe plus atorvastatin) and the control group (n=30, receiving atorvastatin monotherapy). Lipid profiles [including low density lipoprotein cholesterol (LDL-C), total cholesterol (TC), and triglycerides (TG)] and serum inflammatory markers [high sensitivity C reactive protein (hs-CRP) and interleukin 6 (IL-6)] were assessed before and after treatment in both groups. Additionally, the occurrence of MACE during the treatment period was recorded and analyzed. Results: After treatment, there was no significant difference in TG levels and the occurrence of adverse reactions mainly between the two groups (P>0.05). The observation group showed significantly lower levels of TC, LDL-C, hs-CRP, and IL-6 compared to the control group (P<0.05). There was no significant difference in the incidence of adverse reactions between the two groups after treatment (P>0.05). Kaplan-Meier survival analysis demonstrated that the incidence of MACE was significantly lower in the observation group compared to the control group (Log rank χ²=4.667, P=0.031). Conclusions: The combination of ezetimibe and atorvastatin was more effective in lowering lipid and inflammatory levels, demonstrated a trend toward reducing the risk of MACE, and did not significantly increase adverse reactions.