Effect of Combination Therapy of Low-Dose Atorvastatin Plus Ezetimibe Versus Moderate-Intensity Atorvastatin on Hypercholesterolemia in Patients with Acute Coronary Syndrome

Background: Acute coronary syndrome (ACS) is the leading cause of death in the world and it is a consequence of unstable plaque due to dyslipidemia, mainly elevated LDL cholesterol (LDL-C). Methods: This randomized controlled trial was conducted on 80 diagnosed ACS patients with hypercholesterolemia at the department of Pharmacology and Therapeutics in collaboration with the Department of Cardiology, Rajshahi Medical College and Hospital, Rajshahi. The study population was divided into 2 groups. In study group, 40 patients were treated with combination therapy of tablet Atorvastatin (10 mg) plus Ezetimibe (10 mg) and in control group, 40 patients were treated with tablet Atorvastatin (20 mg) alone for 12 weeks. Serum triglyceride, total cholesterol, HDL-C and LDL-C were measured initially at baseline and at the end of the 8th and 12th weeks of drug administration. Results: The reduction of serum total cholesterol and LDL-C from baseline to the 12th week of drug administration was greater in combination therapy group than the monotherapy group which were statistically highly significant (p < 0> 0.05 in both cases). The efficacy was greater in the combination therapy group than in the monotherapy group on considering the achievement rate of LDL-C less than 70 mg/dl and it was found statistically significant (p < 0.05). Conclusion: It might be stated that the combination therapy of Atorvastatin and Ezetimibe for reducing hypercholesterolemia is more beneficial than doubling the dose of Atorvastatin in the case of hypercholesterolemic patients with ACS.