A new study suggests that many heart attacks could be prevented if doctors gave patients a second cholesterol-lowering drug soon after their first heart attack.
This early use of an extra medicine, along with the usual treatment, may help save lives and reduce hospital costs around the world.
The study was carried out by researchers from Lund University in Sweden and Imperial College London. They looked at a common problem: people who survive a heart attack often face a high risk of having another one.
This risk is highest in the first year after the attack, when the blood vessels are more likely to get blocked again. The blockages happen when fat builds up inside the arteries, making them narrow. These areas are sensitive, and clots can form more easily.
Doctors usually give patients strong cholesterol-lowering drugs called statins after a heart attack. Statins help reduce LDL, or “bad” cholesterol, which can help lower the risk of new problems.
But many people don’t reach the recommended low cholesterol levels with statins alone. This is where a second drug, ezetimibe, comes in. Ezetimibe also lowers cholesterol, but in a different way.
Current guidelines tell doctors to start with statins and only add ezetimibe later if needed. But this process can take a long time, and some patients never return for follow-up visits. As a result, they may not get the extra drug at all.
In this study, researchers wanted to know what would happen if patients were given ezetimibe early—within 12 weeks of a heart attack—instead of waiting months or not giving it at all.
They used medical data from over 36,000 Swedish patients who had heart attacks between 2015 and 2022. The team used advanced computer methods to see how early combination treatment affected outcomes.
They found that patients who got both statins and ezetimibe soon after their heart attack were less likely to have another heart attack, stroke, or die from heart-related causes. The benefits were clear compared to those who received ezetimibe much later or not at all.
The researchers believe that this simple change in treatment could prevent many future heart attacks worldwide. For example, in a group of 10,000 patients, they estimated that 133 heart attacks could be avoided in three years.
In the UK, where about 100,000 people are hospitalized for heart attacks every year, this could mean 5,000 fewer heart attacks over ten years.
One of the study’s lead authors, Dr. Margrét Leósdóttir, said that the hesitation to use both drugs early is often due to concerns about giving too much medicine or causing side effects. But ezetimibe is safe, cheap, and widely available.
In Sweden, her hospital has already changed its guidelines. Doctors there now prescribe both drugs right after a heart attack. This has helped more patients reach their cholesterol targets quickly.
Other hospitals in Sweden and abroad have started doing the same, and the results are promising. Dr. Leósdóttir hopes that more hospitals will adopt this approach to help patients avoid future heart problems.
Professor Kausik Ray from Imperial College London added that giving both drugs early would not only save lives but also reduce the costs of treating heart attacks. Ezetimibe costs about £350 per year for each patient, which is much less than treating the long-term effects of a second heart attack.
In conclusion, this large study shows that giving both statins and ezetimibe soon after a heart attack could prevent thousands of serious heart problems around the world. It offers a low-cost, simple solution that could change how doctors treat heart attack patients in the future.
If you care about heart health, please read studies about a new cause of heart rhythm disorders and eating just one cup of nitrate-rich vegetables daily can reduce heart disease risk.
For more about heart health, please read studies about blood thinners that may not prevent stroke in people with heartbeat problems and this diabetes drug may protect heart health in older veterans.
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