What benefits has ezetimibe shown in reducing cardiovascular events and stroke?
Ezetimibe has not been shown to decrease cardiovascular events or stroke. In a study of familial hypercholesterolemia, adding ezetimibe to simvastatin did not affect the progression of carotid IMT more than simvastatin alone.179 In another trial of subjects receiving a statin, niacin led to greater reductions in mean carotid IMT than ezetimibe over 14 months (P=0.003).180 Counterintuitively, patients receiving ezetimibe who had greater reductions in the LDL cholesterol had an increase in the carotid The rate of major cardiovascular events was lower in those randomized to niacin (1% versus 5%; P=0.04). Stroke events were not reported. A clinical outcome trial comparing ezetimibe and simvastatin with simvastatin alone on cardiovascular outcomes is in progress.181