Lipid-lowering monotherapy with ezetimibe may prevent the occurrence of a composite of atherosclerotic cardiovascular events in elderly patients with elevated LDL-C level and no history of coronary artery disease, according to results from the EWTOPIA75 trial presented Nov. 10 at AHA 2018 in Chicago, IL.

Yasuyoshi Ouchi, MD, PhD, et al., looked at 3,796 Japanese elderly patients aged 75 years old or older with no history of coronary artery disease, whose LDL-C level was >140 mg/dL and who had one or more cardiovascular risk factors. Patients were randomly assigned to the ezetimibe group of 10 mg/day plus diet counseling or the control group of diet counseling alone.

Results showed that after five years, the primary endpoint of a composite of sudden cardiac death, fatal myocardial infarction, nonfatal myocardial infarction, coronary revascularization, fatal stroke, and/or nonfatal stroke was higher in the control group vs. the ezetimibe group. Ouchi et al., note that "lowering by ezetimibe monotherapy significantly prevented ASCVD events (hazard ratio 0.66, p=0.002) in elderly patients with elevated LDL-C level."

The researchers conclude that "the result obtained in this study is the first evidence suggesting that the primary prevention of atherosclerotic cardiovascular events is possible by lipid-lowering therapy for eligible older patients aged 75 years or older."

Keywords: AHA18, AHA Annual Scientific Sessions, Hypercholesterolemia, Aged, Cholesterol, LDL

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