← Statins × lipids

TrialJournal of the American College of Cardiology2008

Effect of statins alone versus statins plus ezetimibe on carotid atherosclerosis in type 2 diabetes: the SANDS (Stop Atherosclerosis in Native Diabetics Study) trial.

Jerome L Fleg et al.PubMed ↗Full text ↗Publisher ↗

  • Statins plus ezetimibeno clear effectLower LDL-C reduction.Weak evidence: one subgroup.
  • Statins alonelooks good hereLower LDL-C reduction.Weak evidence: one subgroup.
  • Standard group (target LDL-C <or=100 mg/dl; non-high-density lipoprotein cholesterol <or=130 mg/dl; systolic blood pressure <or=130 mm Hg)no clear effectNo clear effect on LDL-C reduction.Nothing cleared the noise.

What the trial testedrandomised · 2008

One subgroup

May have lowered LDL-C reduction in aggressive group (target LDL-C <or=70 mg/dl; non-high-density lipoprotein cholesterol <or=100 mg/dl; systolic blood pressure <or=115 mm Hg)

−32.0−38.0 to −27.0

statins alone vs statins plus ezetimibe, in aggressive group (target LDL-C <or=70 mg/dl; non-high-density lipoprotein cholesterol <or=100 mg/dl; systolic blood pressure <or=115 mm Hg)

As reported

difference −32.0, 95% CI −38.0 to −27.0

One subgroup

May have lowered LDL-C reduction in aggressive group (target LDL-C <or=70 mg/dl; non-high-density lipoprotein cholesterol <or=100 mg/dl; systolic blood pressure <or=115 mm Hg)

−31.0−37.0 to −23.0

statins plus ezetimibe vs statins alone, in aggressive group (target LDL-C <or=70 mg/dl; non-high-density lipoprotein cholesterol <or=100 mg/dl; systolic blood pressure <or=115 mm Hg)

As reported

difference −31.0, 95% CI −37.0 to −23.0

Range includes no effect

No clear effect on LDL-C reduction

+1.00−3.00 to +6.00

standard group (target LDL-C <or=100 mg/dl; non-high-density lipoprotein cholesterol <or=130 mg/dl; systolic blood pressure <or=130 mm Hg) vs aggressive group (target LDL-C <or=70 mg/dl; non-high-density lipoprotein cholesterol <or=100 mg/dl; systolic blood pressure <or=115 mm Hg)

As reported

difference 1, 95% CI −3.00 to 6.00

+3 more in the walkthrough ↓

Who was studied, and how

people with cardiovascular disease, in this paper

Among aggressive group (target LDL-C <or=70 mg/dl; non-high-density lipoprotein cholesterol <or=100 mg/dl; systolic blood pressure <or=115 mm Hg), the trial randomly assignedassigned by chance

statins plus ezetimibe
statins alone

May have lowered LDL-C reduction−31.0

randomised · one subgroup

Among aggressive group (target LDL-C <or=70 mg/dl; non-high-density lipoprotein cholesterol <or=100 mg/dl; systolic blood pressure <or=115 mm Hg), the trial randomly assignedassigned by chance

statins alone
statins plus ezetimibe

May have lowered LDL-C reduction−32.0

randomised · one subgroup

the abstract, start to end

… intervals) LDL-C was reduced by 31 (23 to 37) mg/dl and 32 (27 to 38) mg/dl in the aggressive group receiving statins plus ezetimibe and statins alone, respectively, compared with changes of 1 (-3 to 6) mg/dl in the standard …

… baseline similarly in the ezetimibe (-0.025 [-0.05 to 0.003] mm) and nonezetimibe subgroups (-0.012 [-0.03 to 0.008] mm) but progressed in the standard treatment arm (0.039 [0.02 to 0.06] mm), intergroup …

← favours treatmentfavours comparator →
could be chance
LDL-C reductionstatins plus ezetimibe vs statins alone, in aggressive group (target LDL-C <or=70 mg/dl; non-high-density lipoprotein cholesterol <or=100 mg/dl; systolic blood pressure <or=115 mm Hg)
−31.0−37.0 to −23.0
LDL-C reductionstatins alone vs statins plus ezetimibe, in aggressive group (target LDL-C <or=70 mg/dl; non-high-density lipoprotein cholesterol <or=100 mg/dl; systolic blood pressure <or=115 mm Hg)
−32.0−38.0 to −27.0
LDL-C reductionstandard group (target LDL-C <or=100 mg/dl; non-high-density lipoprotein cholesterol <or=130 mg/dl; systolic blood pressure <or=130 mm Hg) vs aggressive group (target LDL-C <or=70 mg/dl; non-high-density lipoprotein cholesterol <or=100 mg/dl; systolic blood pressure <or=115 mm Hg)
1−3.00 to 6.00
Change in common carotid artery intima-media thickness (CIMT) from baselinestatins plus ezetimibe, in aggressive group (target LDL-C <or=70 mg/dl; non-high-density lipoprotein cholesterol <or=100 mg/dl; systolic blood pressure <or=115 mm Hg)
−0.025−0.05 to 0.00
Change in common carotid artery intima-media thickness (CIMT) from baselinestatins alone, in aggressive group (target LDL-C <or=70 mg/dl; non-high-density lipoprotein cholesterol <or=100 mg/dl; systolic blood pressure <or=115 mm Hg)
−0.012−0.03 to 0.01
Change in common carotid artery intima-media thickness (CIMT) from baselinestandard treatment, in standard group (target LDL-C <or=100 mg/dl; non-high-density lipoprotein cholesterol <or=130 mg/dl; systolic blood pressure <or=130 mm Hg)
0.0390.02–0.06
StatinsOther lipid agentsLipidsCardiac & vascular function
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The trial

NCT00047424
Full record →Abstract, authors, funding and every citing paper · PMID 19095139