Logo

American Heart Association

  35
  0


Final ID: 4370846

Real-World Outcomes of Inclisiran vs. Ezetimibe in Statin-Treated Coronary Artery Disease Patients: A 1-Year Observational Analysis

Abstract Body (Do not enter title and authors here): Background: Residual risk of adverse cardiovascular events remains high among patients with coronary artery disease (CAD) despite high-intensity statin therapy. Although ezetimibe is the standard non-statin add-on, inclisiran, a PCSK9-targeting siRNA, may confer greater reductions in mortality and major events. We compared 1-year real-world outcomes of inclisiran versus ezetimibe in patients with CAD and hyperlipidemia.
Methods: In this retrospective, propensity score-matched study using the TriNetX US Collaborative Network, adults with CAD (ICD-10 I25.10) and hyperlipidemia (ICD-10 E78.5) on atorvastatin 40–80 mg plus either ezetimibe (n = 136,655 before matching) or inclisiran (n = 1205) from January 2005 to June 2025 were identified. After 1:1 matching (n = 1205 per group) for demographics, comorbidities, concomitant cardiovascular medications, and baseline LDL-C, patients were followed from day +1 to day 365 post-index. The primary endpoint was all-cause mortality; secondary endpoints were acute myocardial infarction (AMI), ischemic/hemorrhagic stroke, and LDL-C ≤ 70 mg/dL at 12 months. Kaplan-Meier curves, log-rank tests, and Cox models estimated hazard ratios (HRs) with 95% confidence intervals (CIs).
Results: Baseline characteristics were balanced (mean age 70 ± 9 years; 44% female; median LDL-C ≈ 105 mg/dL). At 12 months, all-cause mortality was 0.8% with inclisiran versus 3.4% with ezetimibe (HR 0.14; 95% CI 0.06–0.33; p < 0.001). AMI occurred in 10.5% versus 13.3% (HR 0.74; 95% CI 0.59–0.93; p = 0.011), and stroke in 5.8% versus 7.9% (HR 0.70; 95% CI 0.51–0.96; p = 0.023). Achievement of LDL-C ≤ 70 mg/dL was similar (34.5% vs. 31.3%; HR 1.05; 95% CI 0.83–1.09; p = 0.452) as shown in table 1.
Conclusions: In this large, real-world cohort of CAD patients on high-intensity statins, adding inclisiran was associated with an 85% reduction in 1-year all-cause mortality and significant reductions in AMI and stroke compared with ezetimibe, without compromising LDL-C goal attainment. Prospective randomized trials are warranted to confirm these findings.
  • Akbar, Usman  ( WVU Camden Clark , Parkersburg , West Virginia , United States )
  • Ijaz, Hasnan  ( Corpus Christi Medical Center , Corpus Christi , Texas , United States )
  • Cantu, Heriberto  ( Corpus Christi Medical Center , Corpus Christi , Texas , United States )
  • Muhibullah, Fnu  ( Nishtar Medical University, Pakista , Multan , Pakistan )
  • Alexander, Thomas  ( Corpus Christi Medical Center , Corpus Christi , Texas , United States )
  • Author Disclosures:
    Usman Akbar: DO NOT have relevant financial relationships | Hasnan ijaz: No Answer | Heriberto Cantu: DO NOT have relevant financial relationships | Fnu Muhibullah: DO NOT have relevant financial relationships | Thomas Alexander: DO NOT have relevant financial relationships
Meeting Info:

Scientific Sessions 2025

2025

New Orleans, Louisiana

Session Info:

Lipid Lowering Therapies and Lipid Risk Factors

Sunday, 11/09/2025 , 09:45AM - 11:00AM

Abstract Oral Session

More abstracts on this topic:
A Polypill Strategy for Lipid Lowering and Anti-Platelet Therapy After Acute Coronary Syndrome: A Pilot Randomized Controlled Trial

Keshvani Neil, Wang Thomas, Pandey Ambarish, Coellar Juan David, Rizvi Syed Kazim, Jain Anand, Bustillo-rubio M. Karina, Segar Matthew, Lokesh Nidhish, Miller James, Yates Sean

A Novel Machine Learning Strategy to Integrate Multi-Omics Data and Detect Genomic Loci and Gene-Environment Interactions for LDL Cholesterol

Li Changwei, Zhang Ruiyuan, Sun Yixi, Chen Jing, Wang Tao, Bazzano Lydia, Kelly Tanika, He Jiang

More abstracts from these authors:
Recurrent Hemopericardium Following Fibrinolytic Therapy: A Novel Case Requiring Emergency Surgery and Mechanical Circulatory Support

Al-mollah Mustafa, Hussein Moaiad, Alexander Thomas, Ijaz Hasnan, Cuevas Christel, Cantu Heriberto, Mubder Mohamad, Dugal Jasmine, Alalawi Luay

Impact of Atrial Fibrillation on 1-Year Clinical Outcomes in Hypertrophic Cardiomyopathy: A Multicenter Observational Analysis

Akbar Usman, Shakeel Sana, Akbar Ayesha, Banga Akshat, Muhibullah Fnu, Dani Sourbha

You have to be authorized to contact abstract author. Please, Login
Not Available