Compared to high-intensity statin monotherapy, moderate-intensity statin with ezetimibe combination significantly reduced the risk of composite outcome (hazard ratio [HR] 0.84, 95% confidence interval [CI] 0.77–0.92, P < 0.001) as well as individual MI (HR 0.81, 95% CI 0.71–0.94, P = 0.005) and stroke (HR 0.78, 95% CI 0.65–0.93, P = 0.005), but not all-cause death. Low-intensity statin with ezetimibe also significantly reduced the risk of the composite outcomes (HR 0.80, 95% CI 0.66–0.97, P = 0.024) compared to high-intensity statin monotherapy, but the risk of individual outcome did not differ between two groups.
(HR for all-cause mortality close to significance in favor of the combination)
Compared to guideline-recommended high-intensity statin therapy, moderate-intensity statin with ezetimibe further improved the achievement rate of LDL-C in patients with acute ischemic cerebrovascular disease, with a higher reduction magnitude in LDL-C. In terms of safety, there was no significant difference between the two regimens, suggesting that moderate-intensity statin with ezetimibe can also be considered as an initial treatment option for patients with acute ischemic cerebrovascular disease.
Unfortunately they defend “safety” as “liver and renal function tests, and the occurrence of statin-related muscle events within 3 months”. I’d like to see new onset of diabetes or just Hb A1c increase.
I’d rather take higher uric acid levels than muscle soreness or diabetes. I’ve experienced muscle soreness from statins and it was intolerable. For uric acid, you can drink more water.
Anyway now I’m focused on optimizing my BP. Once done I’ll look at lipids. One step at a time… But I guess I’ll start with bempedoic acid/ezetimibe (and/or obicetrapib if approved?).
Dr Rick Johnson agrees that Uric acid is a driver of poor health. He and others have pointed to Uric acid as one of the top handful of biomarkers to keep in range.
I get confused about this. If you search for Dietary Neucliotides here you see people who believe eating yeast is important and will make you live longer. RNA/DNA supplementation. But these are purines and will cause all kinds of trouble. What’s the answer?
Watch your Uric acid. If it is too high then back off purines. Maybe back off gravy, shellfish, sardines before beer or other yeast source if that is important to you.
It’s not only a lipid lowering medication, it is a statin. Monacolin K is another word for lovastatin. Contrary to popular opinion, red yeast rice containing Monacolin K is allowed to be sold as a supplement as long as it is not ‘enhanced’ or have added lovastatin to the product according to the NCCIH.
