Key result
Ezetimibe/simvastatin does not alter incident atrial fibrillation risk versus atorvastatin.
Why the study?
The study was conducted to evaluate the role of ezetimibe/simvastatin combination therapy versus atorvastatin in predicting incident atrial fibrillation among patients with type 2 diabetes mellitus, acute coronary syndrome, and acute ischemic stroke.
Does ezetimibe 10 mg/simvastatin 20 mg reduce incident atrial fibrillation in type 2 diabetes mellitus patients with acute coronary syndrome and acute ischemic stroke compared to atorvastatin 40 mg?
Cohort
Yes
Does ezetimibe 10 mg/simvastatin 20 mg reduce incident atrial fibrillation in type 2 diabetes mellitus patients with acute coronary syndrome and acute ischemic stroke compared to atorvastatin 40 mg?
Effect estimate: HR 0.85 (95% CI 0.52-1.38)
Combination therapy with ezetimibe/simvastatin does not significantly alter the risk of incident atrial fibrillation compared to high-intensity atorvastatin in diabetic patients with extensive vascular disease.
No significant AF risk difference seen with ezetimibe/simvastatin versus atorvastatin; leaves open lipid-lowering effects on AF in high-risk diabetes.
The objective was to assess the role of the combination approach with ezetimibe 10 mg/simvastatin 20 mg versus atorvastatin 40 mg in predicting atrial fibrillation (AF) in type 2 diabetes mellitus patients with acute coronary syndrome and acute ischemic stroke. The authors formed a cohort of diabetic patients with extensive vascular diseases between 2000 and 2018 using data from the National Health Insurance Research Database in Taiwan. AF was the outcome of interest in this study. Cox proportional hazards regression analysis was performed to estimate the hazard ratios and 95% confidence intervals in the analysis. After controlling for sex, age, comorbidities and medications, the patients coexisting with type 2 diabetes mellitus, acute coronary syndrome and acute ischemic stroke with ezetimibe 10 mg/simvastatin 20 mg treatment were not significantly at risk of AF, compared to the patients with atorvastatin 40 mg treatment (adjusted hazard ratio, 0.85; 95% confidence interval, 0.52-1.38). A similar effect for AF risk between ezetimibe 10 mg/simvastatin 20 mg and atorvastatin 40 mg users was observed in the current investigation.
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Hu et al. (2023) conducted a cohort in Type 2 diabetes mellitus with acute coronary syndrome and acute ischemic stroke. ezetimibe/simvastatin vs. atorvastatin 40 mg was evaluated on incident atrial fibrillation (HR 0.85, 95% CI 0.52-1.38). Ezetimibe 10 mg/simvastatin 20 mg did not significantly alter the risk of incident atrial fibrillation compared to atorvastatin 40 mg (HR 0.85; 95% CI 0.52-1.38).
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