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Background <p>Achieving target low-density lipoprotein cholesterol (LDL-C) levels in patients with atherosclerotic cardiovascular disease (ASCVD) frequently requires combination lipid-lowering therapy. Single-pill combination (SPC) regimens may improve adherence compared with free-dose combinations (FDC) in real-world clinical practice.</p> Methods <p>This retrospective observational study included 450 ASCVD patients with baseline LDL-C levels of 70–189&#xa0;mg/dL who were followed in cardiology outpatient clinics between January 2023 and December 2024. Patients received atorvastatin–ezetimibe either as a single-pill combination (SPC, <i>n</i> = 392) or as a free-dose combination (FDC, <i>n</i> = 58). Primary endpoints were LDL-C reduction and treatment adherence (≥ 80% of prescribed doses). Secondary endpoints included LDL-C target attainment and adverse events. Non-parametric tests and chi-square/Fisher’s exact tests were used for statistical analysis.</p> Results <p>At 1 month, LDL-C levels were significantly lower in the SPC group compared with the FDC group (90.6 vs. 119&#xa0;mg/dL; <i>p</i> = 0.005), and adherence was higher (89.8% vs. 70.7%; <i>p</i> &lt; 0.001). At 4 months, LDL-C levels were comparable between groups, while continuous adherence remained significantly higher in the SPC group (86% vs. 69%; <i>p</i> = 0.001). A higher proportion of SPC-treated patients achieved LDL-C &lt; 100&#xa0;mg/dL at 1 month (81.9% vs. 67.2%; <i>p</i> = 0.009).</p> Conclusions <p>In this real-world ASCVD cohort, SPC therapy with atorvastatin and ezetimibe was associated with superior adherence and comparable lipid-lowering efficacy despite lower statin doses. Fixed-dose combination strategies may represent an effective approach to optimize adherence and cardiovascular risk management.</p>

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Efficacy and safety of combination therapy with statin and ezetimibe in patients failing to achieve target LDL levels at cardiology outpatient clinics in Turkey (COM-TR-OLDL): a real-world observational study

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月6日

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  • Ayşe Çolak,
  • Zeynep Kumral,
  • Önder Öztürk,
  • Ayşegül Ülgen Kunak,
  • Ali Nizami Elmas,
  • Ömer Bedir,
  • Medeni Karaduman,
  • Naci Babat,
  • Umut Uyan,
  • Nurcemal Şentürk,
  • Sebahat Tekeli Şengül,
  • Sefa Erdi Ömür,
  • Şahbender Koç,
  • Mehmet Ali Işık,
  • Samet Uysal,
  • Cennet Yıldız,
  • Emre Asiltürk,
  • Tuncay Güzel,
  • Fahri Er,
  • Alkım Ateşli Yazıcı,
  • Emrah Yeşil,
  • Fuat Bice,
  • Cansu Öztürk,
  • Murat Gökhan Yerlikaya,
  • Lütfü Aşkın,
  • Melisa Uçar,
  • Murat Çakır,
  • Ömer Uluuysal,
  • Afag Özyıldız,
  • Yusuf Demir Ozan,
  • Tolga Kunak,
  • Selçuk Öztürk,
  • Özkan Karaca,
  • Özkan Kayhan,
  • Khayal Mirzayev,
  • İlke Çelikkale,
  • Emine Buket Kırdağ,
  • Mehdi Zoghi,
  • Asım Oktay Ergene

摘要

Background

Achieving target low-density lipoprotein cholesterol (LDL-C) levels in patients with atherosclerotic cardiovascular disease (ASCVD) frequently requires combination lipid-lowering therapy. Single-pill combination (SPC) regimens may improve adherence compared with free-dose combinations (FDC) in real-world clinical practice.

Methods

This retrospective observational study included 450 ASCVD patients with baseline LDL-C levels of 70–189 mg/dL who were followed in cardiology outpatient clinics between January 2023 and December 2024. Patients received atorvastatin–ezetimibe either as a single-pill combination (SPC, n = 392) or as a free-dose combination (FDC, n = 58). Primary endpoints were LDL-C reduction and treatment adherence (≥ 80% of prescribed doses). Secondary endpoints included LDL-C target attainment and adverse events. Non-parametric tests and chi-square/Fisher’s exact tests were used for statistical analysis.

Results

At 1 month, LDL-C levels were significantly lower in the SPC group compared with the FDC group (90.6 vs. 119 mg/dL; p = 0.005), and adherence was higher (89.8% vs. 70.7%; p < 0.001). At 4 months, LDL-C levels were comparable between groups, while continuous adherence remained significantly higher in the SPC group (86% vs. 69%; p = 0.001). A higher proportion of SPC-treated patients achieved LDL-C < 100 mg/dL at 1 month (81.9% vs. 67.2%; p = 0.009).

Conclusions

In this real-world ASCVD cohort, SPC therapy with atorvastatin and ezetimibe was associated with superior adherence and comparable lipid-lowering efficacy despite lower statin doses. Fixed-dose combination strategies may represent an effective approach to optimize adherence and cardiovascular risk management.