Clinical trial · Supplements / medicine · 7 Nov 2026
In 3,048 people with atherosclerotic cardiovascular disease, starting ezetimibe with a statin did not cut events versus a statin alone over 3 years
Source: Circulation
What the research found
Circulation published a prespecified second randomization on 7 November 2026. At 17 centers in South Korea, from January 2021 through July 2022, 3,048 people with atherosclerotic cardiovascular disease were randomized. The first randomization compared an intensive LDL cholesterol target under 55 mg/dL with a conventional target under 70 mg/dL. The second randomization compared starting a statin plus ezetimibe (1,525 people) with starting a statin alone (1,523 people), with therapy adjusted toward the assigned target over 3 years. Mean age was 64.4 years (standard deviation 9.0), and 638 people (20.9 percent) were women. The primary composite (cardiovascular death, nonfatal myocardial infarction, nonfatal stroke, any revascularization, or a hospital stay for unstable angina) occurred in 128 people on the combination (8.5 percent) versus 119 people on a statin alone (7.9 percent). The hazard ratio was 1.07 (95 percent CI 0.83 to 1.37, P = 0.596). Median LDL cholesterol during follow-up was 53 mg/dL (IQR 45 to 62) with the combination versus 62 (53 to 74) with a statin alone in the intensive arm, and 63 (55 to 73) versus 70 (62 to 81) in the conventional arm. Among people who started on a statin alone, ezetimibe was added later for 241 people (34.3 percent) in the intensive arm and 177 people (24.8 percent) in the conventional arm. The intensive-versus-conventional contrast was similar across the two starting regimens (interaction P = 0.583). Safety was similar. Statin and ezetimibe choices stay with a clinician. DOI 10.1161/CIRCULATIONAHA.126.083811. Not medical advice. Not a substitute for a prescribed medicine. Off-label prescription use is clinician-only. VitaLonga does not diagnose, treat, or cure disease. Never start, stop, or replace a prescription with a supplement on the basis of a headline.
Evidence level: Clinical trial. This is among the stronger kinds of evidence, but one study rarely settles a question.
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