Richard Parks A groundbreaking study conducted by researchers from Imperial College London and Lund University in Sweden reveals that combining two low-cost medications — statins and ezetimibe — soon after a heart attack can significantly reduce the risk of subsequent heart attacks, strokes, and death. The research suggests that early treatment with this combination therapy may dramatically improve patient outcomes, offering a safer, more effective approach to heart attack recovery.
Early Combination Therapy Provides Stronger Protection
The study highlights the critical timing of combining statins and ezetimibe within 12 weeks of a heart attack. According to the findings, patients who received both medications early achieved better cholesterol management and experienced fewer cardiovascular events, including fewer heart attacks and strokes. This early combination therapy was also linked to lower overall mortality compared to patients who only received statins or had ezetimibe added later.
Researchers analyzed data from 36,000 heart attack patients in Sweden, spanning from 2015 to 2022. Using advanced statistical models to simulate a clinical trial, they compared three groups:
- Patients who received statins and ezetimibe within 12 weeks.
- Patients who received ezetimibe 13 weeks to 16 months after the heart attack.
- Patients treated only with statins.
The results showed that the group receiving early combination therapy fared significantly better, underscoring the importance of timely intervention.
Changing Guidelines Could Save Lives
Professor Kausik Ray, a researcher from Imperial’s School of Public Health, emphasized the potential life-saving benefits of adopting this early combination therapy. “This study shows that we could save lives and prevent second heart attacks by prescribing this combination early,” he explained. He also noted that, despite the evidence, patients globally are not routinely prescribed both medications together, which leads to avoidable harm and unnecessary healthcare costs.
The cost of adding ezetimibe is relatively low — estimated at £350 per year per patient — compared to the high long-term costs associated with treating additional heart attacks and their complications. Researchers are now calling for updated treatment guidelines to ensure that more heart attack survivors receive both medications promptly after their initial event.
Safe, Accessible, and Underused
Ezetimibe is widely available, inexpensive, and well tolerated by patients. Despite this, many doctors hesitate to prescribe the drug immediately after a heart attack due to concerns about potential side effects or overmedication, a practice often based on outdated precautionary principles.
Margret Leosdottir, senior cardiology consultant at Skåne University Hospital and co-author of the study, stressed the importance of revisiting this approach. “The evidence now shows that early combination therapy reduces risk. Delaying it means exposing patients to avoidable danger,” she said. She strongly advocates for revising global treatment guidelines to reduce unnecessary suffering and ultimately save lives.
This study provides compelling evidence that a simple, low-cost change in post-heart attack care could have a profound impact on global health. By combining statins and ezetimibe early in the treatment process, doctors can significantly improve patient outcomes, prevent future cardiovascular events, and save lives. Researchers are hopeful that updated guidelines will encourage more widespread use of this combination therapy, benefiting heart attack survivors worldwide.