Metabolic and Safety Outcomes of Statin-Ezetimibe Versus High-Intensity Statin in Older Patients.
JJ, C., Y, S., HJ, J., JH, P., CW, Y., PH, L., SW, L., CW, L., JY, M., & JY, L. (2026). Metabolic and Safety Outcomes of Statin-Ezetimibe Versus High-Intensity Statin in Older Patients.. Journal of the American Heart Association. https://doi.org/10.1161/JAHA.125.048711
JJ C, Y S, HJ J, JH P, CW Y, PH L, et al. Metabolic and Safety Outcomes of Statin-Ezetimibe Versus High-Intensity Statin in Older Patients.. Journal of the American Heart Association. 2026; doi: 10.1161/JAHA.125.048711
JJ C, Y S, HJ J, et al. Metabolic and Safety Outcomes of Statin-Ezetimibe Versus High-Intensity Statin in Older Patients.[J]. Journal of the American Heart Association. 2026. DOI: 10.1161/JAHA.125.048711.
@article{jj2026,
author = {Cha JJ and Shin Y and Joo HJ and Park JH and Yu CW and Lee PH and Lee SW and Lee CW and Moon JY and Lee JY},
title = {Metabolic and Safety Outcomes of Statin-Ezetimibe Versus High-Intensity Statin in Older Patients.},
journal = {Journal of the American Heart Association},
year = {2026},
doi = {10.1161/JAHA.125.048711},
note = {PMID: 42396798},
}
TY - JOUR AU - Cha JJ AU - Shin Y AU - Joo HJ AU - Park JH AU - Yu CW AU - Lee PH AU - Lee SW AU - Lee CW AU - Moon JY AU - Lee JY TI - Metabolic and Safety Outcomes of Statin-Ezetimibe Versus High-Intensity Statin in Older Patients. T2 - Journal of the American Heart Association PY - 2026 DO - 10.1161/JAHA.125.048711 AN - PMID:42396798 ER -
BACKGROUND: High-intensity statins are recommended for secondary prevention in atherosclerotic cardiovascular disease (ASCVD), but older adults frequently experience tolerability issues and adverse metabolic effects. Moderate-intensity statin plus ezetimibe can achieve substantial low-density lipoprotein cholesterol lowering, yet randomized data comparing metabolic and safety outcomes versus high-intensity statins in older patients remain limited. METHODS: This subgroup analysis of the randomized SaveSAMS (Effects of High-Dose Statin Versus Low-Dose Statin Plus Ezetimibe on SAMS and on Reaching Target LDL-Cholesterol Levels Among Older Patients With ASCVD) trial included patients aged ≥70 years with established ASCVD assigned to high-intensity statin monotherapy (rosuvastatin 20 mg) or a moderate-intensity statin plus ezetimibe (rosuvastatin 5 mg/ezetimibe 10 mg). Among 318 patients (monotherapy, n=168; combination, n=150), 6-month changes in lipid parameters, metabolic biomarkers, and safety end points were compared. RESULTS: Both strategies significantly improved lipid profiles. Combination therapy achieved greater non-high-density lipoprotein cholesterol reduction (Δ -76.0 versus -66.0 mg/dL; P=0.047) and attenuated statin-associated increases in lipoprotein(a) (Δ +0.1 versus +1.2 mg/dL; P=0.033). Statin-associated muscle symptoms occurred less frequently with combination therapy (0.7% versus 5.4%; P=0.021). New-onset diabetes did not differ significantly between groups (5.1% versus 14.5%; P=0.065), while changes in glycemic markers were similar. Low-density lipoprotein cholesterol target attainment (<70 and <55 mg/dL) was comparable between groups. CONCLUSIONS: In older patients with ASCVD, a moderate-intensity statin plus ezetimibe provided low-density lipoprotein cholesterol lowering comparable with high-intensity statin monotherapy, with a more favorable metabolic and safety profile, including greater non-high-density lipoprotein cholesterol reduction, stable lipoprotein(a), and fewer muscle symptoms. REGISTRATION: URL: https://www.clinicatrials.gov; Unique Identifier: NCT04826354.