{"id":"7121427a8690","type":"article","url":"https://hartvaat.nl/2023/04/11/matige-statine-plus-ezetimibe-bij-ouderen-met-atherosclerose-jacc-studie/","title":"Matige statine plus ezetimibe bij ouderen met atherosclerose: JACC-studie","title_en":"Combination Moderate-Intensity Statin and Ezetimibe Therapy for Elderly Patients With Atherosclerosis.","category":"cholesterol","category_label":"Cholesterol","professions":["apotheker","cardioloog","huisarts","internist"],"tags":["ezetimibe","statines"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2023.02.007","source_url":"https://doi.org/10.1016/j.jacc.2023.02.007","authors":["Sang-Hyup Lee","Yong-Joon Lee","Jung Ho Heo","Seung-Ho Hur","Hyun Hee Choi","Kyung-Jin Kim","Ju Han Kim","Keun-Ho Park","Jung Hee Lee","Yu Jeong Choi","Seung-Jun Lee","Sung-Jin Hong","Chul-Min Ahn","Byeong-Keuk Kim","Young-Guk Ko","Donghoon Choi","Myeong-Ki Hong","Yangsoo Jang","Jung-Sun Kim"],"significance":7,"published":"2023-04-11","source_date":"2023-04-11","image":"","kennis":["https://hartvaat.nl/kennis/lipiden/ezetimib/","https://hartvaat.nl/kennis/lipiden/lipidenmedicatie-bij-ckd/"],"congress":"","summary_en":"This study confirmed that moderate-intensity statin combined with ezetimibe provides comparable cardiovascular protection to high-intensity statin monotherapy in elderly patients with atherosclerosis, offering a better-tolerated alternative.","created":"2026-07-03T10:30:19Z","updated":"2026-07-03T13:29:23Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie bevestigde dat matige-intensiteit statine met ezetimibe bij ouderen met atherosclerose vergelijkbare cardiovasculaire bescherming biedt als hoge-dosis statine, met minder bijwerkingen. Deze combinatiestrategie is bijzonder geschikt voor de oudere populatie.","abstract_original":"BACKGROUND: The routine use of high-intensity statins should be considered carefully in elderly patients because of their higher risk of intolerance or adverse events. OBJECTIVES: We evaluated the impact of moderate-intensity statin with ezetimibe combination therapy compared with high-intensity statin monotherapy in elderly patients with atherosclerotic cardiovascular disease (ASCVD). METHODS: In this post hoc analysis of the RACING (RAndomized Comparison of Efficacy and Safety of Lipid-lowerING With Statin Monotherapy Versus Statin/Ezetimibe Combination for High-risk Cardiovascular Diseases) trial, patients were stratified by age (≥75 years and <75 years). The primary endpoint was a 3-year composite of cardiovascular death, major cardiovascular events, or nonfatal stroke. RESULTS: Among the 3,780 enrolled patients, 574 (15.2%) were aged ≥75 years. The rates of the primary endpoint were not different between the moderate-intensity statin with ezetimibe combination therapy group and the high-intensity statin monotherapy group among patients aged ≥75 years (10.6% vs 12.3%; HR: 0.87; 95% CI: 0.54-1.42; P = 0.581) and those <75 years (8.8% vs 9.4%; HR: 0.94; 95% CI: 0.74-1.18; P = 0.570) (P for interaction = 0.797). Moderate-intensity statin with ezetimibe combination therapy was associated with lower rates of intolerance-related drug discontinuation or dose reduction among patients aged ≥75 years (2.3% vs 7.2%; P = 0.010) and those <75 years (5.2% vs 8.4%; P < 0.001) (P for interaction = 0.159). CONCLUSIONS: Moderate-intensity statin with ezetimibe combination therapy showed similar cardiovascular benefits to those of high-intensity statin monotherapy with lower intolerance-related drug discontinuation or dose reduction in elderly patients with ASCVD having a higher risk of intolerance, nonadherence, and discontinuation with high-intensity statin therapy. (RAndomized Comparison of Efficacy and Safety of Lipid-lowerING With Statin Monotherapy Versus Statin/Ezetimibe Combination for High-risk Cardiovascular Diseases [RACING Trial]; NCT03044665)."}