People who receive an extra medication soon after a heart attack have a much better chance of avoiding another one, according to a new study by researchers from Lund University in Sweden and Imperial College London.
The study suggests that adding the drug ezetimibe to statin treatment soon after a heart attack could prevent thousands of new heart attacks in the years to come.
Heart attacks are a major global health issue and the leading cause of death worldwide. People who survive a heart attack are at the highest risk of having another one within the first year. This is because their blood vessels are more sensitive and more likely to develop new blood clots.
Doctors usually treat heart attack patients with high-strength statins right away to lower LDL or “bad” cholesterol. Lowering this type of cholesterol helps keep blood vessels stable and reduces the chance of another heart attack. However, many patients don’t reach their target cholesterol levels with statins alone, so they need another drug like ezetimibe.
Current guidelines recommend adding drugs step by step if statins aren’t enough, but this process can be slow and many patients don’t get the extra treatment in time. Dr. Margrét Leósdóttir from Lund University believes starting combination treatment earlier could help prevent many heart attacks.
In the new study, researchers looked at 36,000 heart attack patients in Sweden between 2015 and 2022. They grouped patients based on when they received ezetimibe: within 12 weeks, later between 13 weeks and 16 months, or not at all. They used advanced data analysis to simulate a clinical trial.
They found that patients who received ezetimibe within 12 weeks and were able to lower their cholesterol early had better health outcomes and a lower risk of new heart problems or death. Those who got the drug later or not at all had worse outcomes.
The researchers estimate that if all patients received ezetimibe early, 133 heart attacks could be avoided for every 10,000 people in just three years. In the UK, which sees around 100,000 heart attack hospital admissions each year, this could mean preventing about 5,000 heart attacks over 10 years.
One reason ezetimibe isn’t given earlier is that current medical guidelines don’t recommend it right away, and some doctors are cautious about using multiple drugs. However, the researchers found that ezetimibe is safe, has few side effects, and is affordable.
Dr. Leósdóttir’s hospital in Sweden has already introduced a new treatment plan that helps doctors prescribe the right drugs sooner. Since starting this plan, twice as many patients have reached their cholesterol goals just two months after their heart attack.
Other hospitals in Sweden and some in other countries have adopted similar plans and seen good results. Dr. Leósdóttir hopes more hospitals will follow this example to prevent more heart attacks and save lives.
Professor Kausik Ray from Imperial College London said that making this small change in treatment guidelines could have a big impact. Ezetimibe is already widely available and inexpensive. Using it could reduce healthcare costs and improve the lives of many patients.
If you care about heart health, please read studies that yogurt may help lower the death risks in heart disease, and coconut sugar could help reduce artery stiffness.
For more information about health, please see recent studies that Vitamin D deficiency can increase heart disease risk, and results showing vitamin B6 linked to lower death risk in heart disease.
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