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The lipid-lowering tandem of simvastatin and ezetimibe (Vytorin) shows little clinical benefit for older patients with aortic stenosis despite lowering cholesterol levels impressively, according to the SEAS trial published online early in the New England Journal of Medicine.
Researchers supported by the manufacturer randomized nearly 1900 patients (mean age, 67 years) with aortic stenosis to receive either Vytorin or placebo. After a median follow-up of more than 4 years, LDL cholesterol levels fell by more than 50% in the treatment group compared with about 4% in the placebo group. Fewer patients receiving Vytorin underwent coronary-artery bypass surgery compared with those receiving placebo. However, no significant differences were observed for the combined endpoint of aortic valve replacement and cardiovascular events.
The surprise finding from the study was an increased cancer incidence with Vytorin compared with placebo.
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LINK(S):
NEJM SEAS study (Free)
Journal Watch Cardiology summary (Free)
Physician's First Watch coverage of manufacturer press release on SEAS (Free)