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
Makaleler > Tam Makale · 2026
Yazarlar: 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 ZOGHİ, Asım Oktay Ergene
Lipids in Health and Disease, Uluslararası, Wos, 2026, cilt 25
DOI: 10.1186/s12944-026-02950-1
Özet
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.