{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T07:28:49Z","timestamp":1789025329939,"version":"build-2803163510"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"11","license":[{"start":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T00:00:00Z","timestamp":1671408000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Cardiovascular Research Center"},{"name":"Hanmi Pharmaceutical"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,3,14]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>This study evaluated the effect of moderate-intensity statin with ezetimibe combination therapy vs. high-intensity statin monotherapy among patients with diabetes mellitus (DM) and atherosclerotic cardiovascular disease (ASCVD).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods and results<\/jats:title><jats:p>This was a pre-specified, stratified subgroup analysis of the DM cohort in the RACING trial. The primary outcome was a 3-year composite of cardiovascular death, major cardiovascular events, or non-fatal stroke. Among total patients, 1398 (37.0%) had DM at baseline. The incidence of the primary outcome was 10.0% and 11.3% among patients with DM randomized to ezetimibe combination therapy vs. high-intensity statin monotherapy (hazard ratio: 0.89; 95% confidence interval: 0.64\u20131.22; P = 0.460). Intolerance-related discontinuation or dose reduction of the study drug was observed in 5.2% and 8.7% of patients in each group, respectively (P = 0.014). LDL cholesterol levels &amp;lt;70 mg\/dL at 1, 2, and 3 years were observed in 81.0%, 83.1%, and 79.9% of patients in the ezetimibe combination therapy group, and 64.1%, 70.2%, and 66.8% of patients in the high-intensity statin monotherapy group (all P &amp;lt; 0.001). In the total population, no significant interactions were found between DM status and therapy regarding primary outcome, intolerance-related discontinuation or dose reduction, and the proportion of patients with LDL cholesterol levels &amp;lt;70 mg\/dL.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Ezetimibe combination therapy effects observed in the RACING trial population are preserved among patients with DM. This study supports moderate-intensity statin with ezetimibe combination therapy as a suitable alternative to high-intensity statins if the latter cannot be tolerated, or further reduction in LDL cholesterol is required among patients with DM and ASCVD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Clinical Trial Registration<\/jats:title><jats:p>ClinicalTrials.gov, Identifier:NCT03044665.<\/jats:p><\/jats:sec>","DOI":"10.1093\/eurheartj\/ehac709","type":"journal-article","created":{"date-parts":[[2022,12,19]],"date-time":"2022-12-19T06:37:06Z","timestamp":1671431826000},"page":"972-983","source":"Crossref","is-referenced-by-count":55,"title":["Moderate-intensity statin with ezetimibe vs. high-intensity statin in patients with diabetes and atherosclerotic cardiovascular disease in the RACING trial"],"prefix":"10.1093","volume":"44","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4526-6120","authenticated-orcid":false,"given":"Yong-Joon","family":"Lee","sequence":"first","affiliation":[{"name":"Division of Cardiology, Severance Hospital, Yonsei University College of Medicine , Yonsei-ro 50-1, Seoul 03722 , Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jae Young","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Wonkwang University Hospital , Muwang-ro 895, Iksan 54538 , Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seng Chan","family":"You","sequence":"additional","affiliation":[{"name":"Department of Biomedical Systems Informatics, Yonsei University College of Medicine, Yonsei-ro 50-1 , Seoul 03722 , Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yong-Ho","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Severance Hospital, Yonsei University College of Medicine , Yonsei-ro 50-1, Seoul 03722 , Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kyeong Ho","family":"Yun","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, Wonkwang University Hospital , Muwang-ro 895, Iksan 54538 , Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yun-Hyeong","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Hanyang University College of Medicine, Hwasu-ro 14 beon-gil 55 , Goyang 10475 , Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Won-Yong","family":"Shin","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Soonchunhyang University Cheonan Hospital , Suncheonhyang 6-gil 31, Cheonan 31151 , Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sang Wook","family":"Im","sequence":"additional","affiliation":[{"name":"Department of Cardiology, CHA University College of Medicine , Yatap-ro 59, Seongnam 13496 , Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Woong Chol","family":"Kang","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Gachon University College of Medicine , Namdong-daero 774 beon-gil 21, Incheon 21565 , Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongwhi","family":"Park","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Gyeongsang National University Changwon Hospital , Samjeongja-ro 11, Changwon 51472 , Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sung Yoon","family":"Lee","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Inje University Ilsan Paik Hospital , Juhwa-ro 170, Ilsan 10380 , Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seung-Jun","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology, 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