Giving patients a combination of cholesterol-lowering drugs earlier in their treatment could prevent thousands of heart attacks and save lives, according to new research by scientists at Lund University in Sweden and Imperial College London. The study highlights that treating patients promptly with both statins and ezetimibe – a low-cost drug already widely available – could significantly reduce the risk of further cardiovascular events, especially in the critical first year following a heart attack.
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The researchers examined data from 36,000 patients who experienced heart attacks between 2015 and 2022, using the Swedish registry and advanced statistical modelling to simulate clinical trials. Patients who began combination therapy within 12 weeks of their heart attack and reached target cholesterol levels early had the lowest risk of recurrent events and death. Delaying ezetimibe or omitting it entirely led to worse outcomes, underscoring the importance of early intervention.
Professor Kausik Ray from Imperial College London emphasised that current care pathways are not making full use of the available treatments. “Our study shows the way forward. Patients around the world are not being given these two safe, inexpensive drugs together, and that is leading to avoidable deaths and extra pressure on healthcare systems,” he said. Researcher Dr Margret Leosdottir added that earlier use of combination therapy could make a meaningful difference, preventing numerous heart attacks across patient populations.
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Despite concerns among clinicians about over-medication and potential side effects, the researchers argue that ezetimibe is well-tolerated and cost-effective – estimated at just £350 per year per patient. In the UK alone, with 100,000 hospital admissions for heart attacks annually, the proposed change in treatment could prevent an estimated 5,000 heart attacks over a decade. The study concludes that medical guidelines need to be updated to reflect this evidence, helping to reduce both personal and systemic burdens of cardiovascular disease.
