{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2024,8,9]],"date-time":"2024-08-09T04:29:48Z","timestamp":1723177788712},"reference-count":24,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2015,8,18]],"date-time":"2015-08-18T00:00:00Z","timestamp":1439856000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2015,12]]},"abstract":"ABSTRACT<\/jats:title>This analysis investigated the extent of different outcome reductions from low\u2010density lipoprotein cholesterol (LDL<\/jats:styled-content>\u2010C) lowering following ezetimibe\/simvastatin treatment and the proportionality of outcome to LDL<\/jats:styled-content>\u2010C reductions. The authors searched PubMed<\/jats:styled-content> between 1997 and mid\u2010June 2015 (any language) and the Cochrane Library to identify all randomized controlled trials comparing ezetimibe\/simvastatin with placebo or less intensive LDL<\/jats:styled-content>\u2010C lowering. Risk ratios (RR<\/jats:styled-content>) and 95% confidence intervals (CIs<\/jats:styled-content>), standardized to 20\u2009mg\/dL LDL<\/jats:styled-content>\u2010C reduction, were calculated for 5 primary outcomes (fatal and nonfatal) and 4 secondary outcomes (non\u2010cardiovascular [CV<\/jats:styled-content>] death, cancer, myopathy, and hepatopathy). Five ezetimibe\/simvastatin RCTs<\/jats:styled-content> (30\u2003051 individuals) were eligible, 2 comparing ezetimibe\/simvastatin vs placebo and 3 vs less intensive treatment. Outcomes reduced almost to the same extent were stroke (RR<\/jats:styled-content>: \u221213%, 95% CI<\/jats:styled-content>: \u221221% to \u22123%), coronary heart disease (CHD<\/jats:styled-content>; RR<\/jats:styled-content>: \u221212%, 95% CI<\/jats:styled-content>: \u221219% to \u22125%), and composite of stroke and CHD<\/jats:styled-content> (RR<\/jats:styled-content>: \u221214%, 95% CI<\/jats:styled-content>: \u221220% to \u22128%). Absolute risk reductions: 5 strokes, 10 CHD<\/jats:styled-content> events, and 16 stroke and CHD<\/jats:styled-content> events prevented for every 1000 patients treated for 5 years. Residual risk was almost 7\u00d7 higher than absolute risk reduction for all the above outcomes. All death outcomes were not reduced, and secondary outcomes did not differ between groups. Logarithmic risk ratios were not associated with LDL<\/jats:styled-content>\u2010C lowering. Our meta\u2010analysis provides evidence that, in patients with different CV<\/jats:styled-content> disease burden, major CV<\/jats:styled-content> events are safely reduced by LDL<\/jats:styled-content>\u2010C lowering with ezetimibe\/simvastatin, while raising the hypothesis that the extent of LDL<\/jats:styled-content>\u2010C lowering might not be accompanied by incremental clinical\u2010event reduction.<\/jats:p>","DOI":"10.1002\/clc.22441","type":"journal-article","created":{"date-parts":[[2015,8,18]],"date-time":"2015-08-18T06:44:56Z","timestamp":1439880296000},"page":"763-769","source":"Crossref","is-referenced-by-count":11,"title":["Effect of Low\u2010Density Lipoprotein Cholesterol Lowering by Ezetimibe\/Simvastatin on Outcome Incidence: Overview, Meta\u2010Analyses, and Meta\u2010Regression Analyses of Randomized Trials"],"prefix":"10.1002","volume":"38","author":[{"given":"Costas","family":"Thomopoulos","sequence":"first","affiliation":[{"name":"Department of Cardiology Helena Venizelou Hospital Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"George","family":"Skalis","sequence":"additional","affiliation":[{"name":"Department of Cardiology Helena Venizelou Hospital Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Helena","family":"Michalopoulou","sequence":"additional","affiliation":[{"name":"Department of Cardiology Helena Venizelou Hospital Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Costas","family":"Tsioufis","sequence":"additional","affiliation":[{"name":"First Cardiology Clinic, Hippokration Hospital Athens University Athens Greece"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Makris","sequence":"additional","affiliation":[{"name":"Department of Cardiology Helena Venizelou Hospital Athens 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