This work included 18144 patients from 39 countries that were admitted pursuing an acute coronary syndrome (with or without ST segment elevation) randomized 1: 1 to receive the combination of simvastatin 40 mg / ezetimibe 10 mg (n = 9067) or simvastatin 40 mg alone (n = 9077). Of the total, 88% received a coronary angiography and 70% angioplasty. 42% of patients in both branches discontinued treatment prematurely. The combined primary end point of cardiovascular death, myocardial infarction, hospitalization for unstable angina and revascularization favoring the group receiving the combination of simvastatin / ezetimibe (32.7% versus 34.7%; p = 0.016). This corresponds to a number needed to treat (NNT) of 50 patients to prevent one event.

Conclusion

In patients admitted undergoing an acute coronary syndrome the combining simvastatin / ezetimibe is superior to simvastatin alone in reducing events.

Sabina A. Murphy
2015-03-18

Original title: IMProved Reduction of Outcomes: Vytorin Efficacy International- IMPROVE-IT.