{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T05:20:21Z","timestamp":1787721621414,"version":"build-2784847793"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"13","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,7,7]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">High\u2010intensity statins are recommended for secondary prevention in atherosclerotic cardiovascular disease (ASCVD), but older adults frequently experience tolerability issues and adverse metabolic effects. Moderate\u2010intensity statin plus ezetimibe can achieve substantial low\u2010density lipoprotein cholesterol lowering, yet randomized data comparing metabolic and safety outcomes versus high\u2010intensity statins in older patients remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">This subgroup analysis of the randomized SaveSAMS (Effects of High\u2010Dose Statin Versus Low\u2010Dose Statin Plus Ezetimibe on SAMS and on Reaching Target LDL\u2010Cholesterol Levels Among Older Patients With ASCVD) trial included patients aged \u226570\u2009years with established ASCVD assigned to high\u2010intensity statin monotherapy (rosuvastatin 20\u2009mg) or a moderate\u2010intensity statin plus ezetimibe (rosuvastatin 5\u2009mg\/ezetimibe 10\u2009mg). Among 318 patients (monotherapy, n=168; combination, n=150), 6\u2010month changes in lipid parameters, metabolic biomarkers, and safety end points were compared.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      Both strategies significantly improved lipid profiles. Combination therapy achieved greater non\u2013high\u2010density lipoprotein cholesterol reduction (\u0394 \u221276.0 versus \u221266.0\u2009mg\/dL;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.047) and attenuated statin\u2010associated increases in lipoprotein(a) (\u0394 +0.1 versus +1.2\u2009mg\/dL;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.033). Statin\u2010associated muscle symptoms occurred less frequently with combination therapy (0.7% versus 5.4%;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.021). New\u2010onset diabetes did not differ significantly between groups (5.1% versus 14.5%;\n                      <jats:italic toggle=\"no\">P<\/jats:italic>\n                      =0.065), while changes in glycemic markers were similar. Low\u2010density lipoprotein cholesterol target attainment (&lt;70 and &lt;55\u2009mg\/dL) was comparable between groups.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">In older patients with ASCVD, a moderate\u2010intensity statin plus ezetimibe provided low\u2010density lipoprotein cholesterol lowering comparable with high\u2010intensity statin monotherapy, with a more favorable metabolic and safety profile, including greater non\u2013high\u2010density lipoprotein cholesterol reduction, stable lipoprotein(a), and fewer muscle symptoms.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Registration<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      URL:\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/www.clinicatrials.gov\">https:\/\/www.clinicatrials.gov<\/jats:ext-link>\n                      ; Unique Identifier: NCT04826354.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.048711","type":"journal-article","created":{"date-parts":[[2026,7,3]],"date-time":"2026-07-03T10:24:28Z","timestamp":1783074268000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Metabolic and Safety Outcomes of Statin\u2013Ezetimibe Versus High\u2010Intensity Statin in Older Patients"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8299-1877","authenticated-orcid":false,"given":"Jung\u2010Joon","family":"Cha","sequence":"first","affiliation":[{"name":"Korea University College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7657-8640","authenticated-orcid":false,"given":"Yonghoon","family":"Shin","sequence":"additional","affiliation":[{"name":"Korea University College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1846-8464","authenticated-orcid":false,"given":"Hyung Joon","family":"Joo","sequence":"additional","affiliation":[{"name":"Korea University College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8434-0157","authenticated-orcid":false,"given":"Jae Hyoung","family":"Park","sequence":"additional","affiliation":[{"name":"Korea University College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5871-4562","authenticated-orcid":false,"given":"Cheol Woong","family":"Yu","sequence":"additional","affiliation":[{"name":"Korea University College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7339-9188","authenticated-orcid":false,"given":"Pil Hyung","family":"Lee","sequence":"additional","affiliation":[{"name":"University of Ulsan College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2662-5952","authenticated-orcid":false,"given":"Seung Whan","family":"Lee","sequence":"additional","affiliation":[{"name":"University of Ulsan College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3987-2159","authenticated-orcid":false,"given":"Cheol Whan","family":"Lee","sequence":"additional","affiliation":[{"name":"University of Ulsan College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8775-3539","authenticated-orcid":false,"given":"Jae Youn","family":"Moon","sequence":"additional","affiliation":[{"name":"CHA University","place":["Seongnam, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5737-4968","authenticated-orcid":false,"given":"Jong\u2010Young","family":"Lee","sequence":"additional","affiliation":[{"name":"Sungkyunkwan University School of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2263-3274","authenticated-orcid":false,"given":"Jung\u2010Sun","family":"Kim","sequence":"additional","affiliation":[{"name":"Yonsei University College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5264-1235","authenticated-orcid":false,"given":"Jae Suk","family":"Park","sequence":"additional","affiliation":[{"name":"Incheon Sejong Hospital","place":["Incheon, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4832-6678","authenticated-orcid":false,"given":"Soon Jun","family":"Hong","sequence":"additional","affiliation":[{"name":"Korea University College of Medicine","place":["Seoul, Republic of Korea"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0000000000000625"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehaf190"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz455"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1410489"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(22)00916-3"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1111\/joim.2002910.1111\/joim.20029"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.860"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehac709"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehz310"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13300-020-00778-1"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ahj.2023.03.002"},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacl.2014.03.004"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365-2796.2012.02592.x"},{"key":"e_1_3_2_15_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehq386"},{"key":"e_1_3_2_16_2","doi-asserted-by":"publisher","DOI":"10.1097\/MED.0000000000000237"},{"key":"e_1_3_2_17_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2017.11.014"},{"key":"e_1_3_2_18_2","doi-asserted-by":"publisher","DOI":"10.5543\/tkda.2024.37794"},{"key":"e_1_3_2_19_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-018-0870-1"},{"key":"e_1_3_2_20_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2012.366"},{"key":"e_1_3_2_21_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(12)60367-5"},{"key":"e_1_3_2_22_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2012.08.1026"},{"key":"e_1_3_2_23_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2020.10.008"},{"key":"e_1_3_2_24_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(09)61965-6"},{"key":"e_1_3_2_25_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.numecd.2017.03.001"},{"key":"e_1_3_2_26_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.biopha.2016.06.029"},{"key":"e_1_3_2_27_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bcp.2019.02.025"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.125.048711","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T04:34:43Z","timestamp":1787718883000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.125.048711"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,7]]},"references-count":26,"journal-issue":{"issue":"13","published-print":{"date-parts":[[2026,7,7]]}},"alternative-id":["10.1161\/JAHA.125.048711"],"URL":"https:\/\/doi.org\/10.1161\/jaha.125.048711","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,7]]},"assertion":[{"value":"2025-12-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-05-21","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-03","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e048711"}}