Early drug combo after a heart attack can save thousands of lives

A simple change in drug timing can prevent thousands of repeated heart attacks, new research from the University of London and Imperial College London says. The study showed that heart attack survivors who received a combination of statin and ezetimibe within 12 weeks had much better outcomes than those who received delayed treatment.

For millions of people who survive heart attacks around the world each year, the risk of experiencing another type of person remains the highest in the first 12 months. During this critical period, blood vessels are particularly susceptible to the formation of new clots.

The international team analyzed data from 36,000 Swedish patients who experienced heart attacks between 2015 and 2022. Their findings challenge current step-by-step treatments.

“Today’s guidance recommends a step-by-step approach to increasing lipid reduction treatments. However, typically this escalation is too long and ineffective and patients lose follow-up,” explained Dr. Margrét Leósdóttir, associate professor at Lund University and senior cardiology consultant at Scoon University Hospital.

The study, published in the Journal of the American College of Cardiology, uses advanced statistical modeling to compare the results in three groups of patients: patients receiving early combination therapy (within 12 weeks), those receiving delayed combination therapy (between 13 weeks and 16 months), and those receiving only those without Ezetimibe intravenous toxins.

The results clearly demonstrate that subsequent cardiovascular events and mortality rates in patients receiving early combined therapy were lower.

In the UK alone, there are about 100,000 hospitalizations a year due to heart attacks, and researchers estimate that this treatment can prevent about 5,000 repeated heart attacks over a decade.

Professor Kausik Ray from the School of Public Health of Imperial College London said: “This study shows that we can save lives and reduce further heart attacks by providing patients with a combination of two low-cost drugs. But for the moment, patients around the world have not yet received these drugs together.

Both statins and ezetimibe can reduce LDL or “bad” cholesterol through different mechanisms. Statins reduce cholesterol production in the liver, while ezetimibe blocks absorption in the intestine. Current guidelines usually recommend starting with high power tines and then adding ezetimibe if needed.

The researchers’ modeling shows that if 100% of patients received ezetimibe early, 133 heart attacks could be avoided per 10,000 patients in just three years.

Despite compelling data, there are obstacles to implementing early combination therapy. “For two main reasons, combination therapy is not performed,” explains Dr. Leósdóttir. “General recommendations are not included in today’s guidelines and adopt preventive principles to avoid side effects and excessive effects.”

However, she noted that Ezetimibe had few side effects and was affordable and widely available in many countries.

Some hospitals are already changing their approach. Skåne University Hospital in Sweden has proposed a therapeutic algorithm that can help doctors prescribe appropriate lipid-lowering drugs for patients with heart attacks. Early results showed that compared with previous regimens, twice as many patients who reached target cholesterol levels two months after a heart attack.

Professor Lei stressed the financial benefit: “Our findings suggest that simple changes in treatment guidelines may have a huge impact on patients and reduce the need for NHS. Ezetimibe is already widely available and prescribed for relatively low costs. This supplemental treatment may be launched at a rate of £350 per year, which is a huge cost per patient, a huge reduction, which is an impact on patients and affects the impact on patients.

Dr. Leósdóttir hopes that more hospitals will review their procedures: “I hope that more hospitals will review their procedures so that more patients can get the right treatment in a timely manner, so we can prevent unnecessary pain and save lives.”