Giving heart attack patients a combination of two cholesterol-lowering drugs soon after the event may greatly improve their chances of avoiding another heart attack, according to a new study from Lund University in Sweden and Imperial College London.
The research shows that treating patients earlier with statins and a second drug called ezetimibe could prevent thousands of repeat heart attacks over time.
Heart disease is the leading cause of death worldwide. A heart attack (also called a myocardial infarction) is the most common serious event linked to heart disease. People who survive a heart attack are at highest risk of having another one in the first year. That’s because their blood vessels are still very sensitive and more likely to develop clots.
Doctors already use statins to lower LDL or “bad” cholesterol, which can help protect blood vessels after a heart attack. But for many people, statins alone are not enough to bring cholesterol levels down to the target range. That’s where ezetimibe, an add-on medication, comes in.
Current medical guidelines suggest adding ezetimibe only if statins aren’t working well enough. But researchers say this step-by-step approach is often too slow. Some patients fall through the cracks and don’t get the extra medicine in time.
The new study suggests that giving both drugs right away, instead of waiting, can help reduce the risk of future heart attacks.
Dr. Margrét Leósdóttir, the senior author of the study, said, “By giving combination treatment earlier, we could prevent many more heart attacks.” Professor Kausik Ray from Imperial College added, “These are two low-cost drugs that are already available. Using them together early could save lives and reduce strain on healthcare systems.”
The study looked at data from 36,000 heart attack patients in Sweden between 2015 and 2022. The researchers compared three groups: patients who got both drugs within 12 weeks of their heart attack, patients who got ezetimibe later, and patients who got only statins.
The results showed that early combination treatment worked best. These patients reached their cholesterol goals sooner and had fewer heart problems and deaths later on.
Based on their findings, the team believes that using early combination treatment in every heart attack patient could prevent about 133 heart attacks in every 10,000 patients over three years. In the UK alone, where there are roughly 100,000 hospital admissions for heart attacks each year, that could mean preventing around 5,000 heart attacks over 10 years.
One reason early combination therapy isn’t common yet is that current guidelines don’t recommend it for all patients. There’s also concern about giving too much medication too soon. However, the researchers point out that ezetimibe has very few side effects and is inexpensive.
Dr. Leósdóttir’s hospital in Sweden has already introduced a new treatment approach that helps doctors prescribe both medicines early. As a result, twice as many patients are hitting their cholesterol targets just two months after a heart attack.
Other hospitals in Sweden and elsewhere have also started using similar strategies with good results. The researchers hope that more hospitals and health systems will adopt this approach to help more people recover and stay healthy after a heart attack.
Professor Ray said, “This simple change in treatment could make a big difference for patients and also reduce costs for the NHS. Ezetimibe is affordable and widely available—it’s time we make better use of it.”
If you care about heart health, please read studies that vitamin K helps cut heart disease risk by a third, and a year of exercise reversed worrisome heart failure.
For more health information, please see recent studies about supplements that could help prevent heart disease, stroke, and results showing this food ingredient may strongly increase heart disease death risk.
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