{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T14:35:03Z","timestamp":1790087703354,"version":"4.0.1"},"reference-count":54,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2024,8,12]],"date-time":"2024-08-12T00:00:00Z","timestamp":1723420800000},"content-version":"vor","delay-in-days":11,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2024,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>It remains controversial whether adding ezetimibe to low\/moderate\u2010intensity statins has a more beneficial impact on the treatment efficacy and safety of patients with existing atherosclerotic cardiovascular disease (ASCVD) compared to high\u2010intensity statin regimens.<\/jats:p><\/jats:sec><jats:sec><jats:title>Hypothesis<\/jats:title><jats:p>A combination of low\/moderate\u2010intensity statins plus ezetimibe might be more effective and safer than high\u2010intensity statin monotherapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We searched databases for randomized controlled trials comparing lipid profile alterations, drug\u2010related adverse events, and MACE components between high\u2010intensity statin monotherapy and low\/moderate\u2010intensity statin plus ezetimibe combination therapy. Pooled risk ratios (RR), mean differences (MD), and 95% confidence intervals (95% CI) were estimated using a random\u2010effects model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Our comprehensive search resulted in 32 studies comprising 6162 patients treated with monotherapy against 5880 patients on combination therapy. Combination therapy was more effective in reducing low\u2010density lipoprotein cholesterol (LDL\u2010C) levels compared to monotherapy (MD\u2009=\u2009\u22126.6, 95% CI: \u221210.6 to \u22122.5); however, no significant differences were observed in other lipid parameters. Furthermore, the combination therapy group experienced a lower risk of myalgia (RR\u2009=\u20090.27, 95% CI: 0.13\u20130.57) and discontinuation due to adverse events (RR\u2009=\u20090.61, 95% CI: 0.51\u20130.74). The occurrence of MACE was similar between the two treatment groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Adding ezetimibe to low\/moderate\u2010intensity statins resulted in a greater reduction in LDL\u2010C levels, a lower rate of myalgia, and less drug discontinuation compared to high\u2010intensity statin monotherapy in patients with existing cardiovascular disease. However, according to our meta\u2010analysis, the observed reduction in LDL\u2010C levels in the combination group did not correlate with a reduction in MACE compared to the high\u2010intensity statin group.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.24334","type":"journal-article","created":{"date-parts":[[2024,8,13]],"date-time":"2024-08-13T06:55:11Z","timestamp":1723532111000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":21,"title":["Safety and Effectiveness of High\u2010Intensity Statins Versus Low\/Moderate\u2010Intensity Statins Plus Ezetimibe in Patients With Atherosclerotic Cardiovascular Disease for Reaching LDL\u2010C Goals: A Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2802-4613","authenticated-orcid":false,"given":"Hamidreza","family":"Soleimani","sequence":"first","affiliation":[{"name":"Cardiac Primary Prevention Research 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