Letter by Thomopoulos and Michalopoulou Regarding Article, “Prevention of Stroke With the Addition of Ezetimibe to Statin Therapy in Patients With Acute Coronary Syndrome in IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial)”
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To the Editor:
The IMPROVE-IT (Improved Reduction of Outcomes: Vytorin Efficacy International Trial) post hoc analysis on stroke prevention in patients stabilized after an acute coronary syndrome by Bohula and colleagues1 concludes that potentiated statin treatment with ezetimibe compared with statin treatment alone reduces ischemic strokes, and the extent of this reduction is higher in patients with a history of stroke. However, all first stroke events were not different between the 2 randomized arms of the trial. The interpretation of the results as provided by the authors remains unclear because data on blood pressure control and oral anticoagulant administration were not taken …