# Ez-PAVE: statin plus ezetimibe from the start lowered LDL more, but 3-year events were similar

- Published: 2026-11-08 04:15 UTC
- Section: Life & Health › Medicine
- Tags: Ez-PAVE trial, statin plus ezetimibe, LDL cholesterol lowering, atherosclerotic cardiovascular disease, combination therapy versus monotherapy, LDL target 55 mg/dL, Circulation study, South Korea randomized trial
- URL: https://realtech.media/news/rt-3f79682c0f0d9eaf07a5f142_ez_pave_statin/

**In a randomized trial of 3,048 patients in South Korea, upfront statin plus ezetimibe lowered LDL further, but 3-year event rates did not differ significantly.**

![Ez-PAVE: statin plus ezetimibe from the start lowered LDL more, but 3-year events were similar](https://realtech.media/media/2026/11/978152dd8ee7f2b8.webp)
*ad-hoc-news.de*

On 6 November 2026, the Ez-PAVE trial was presented at the American Heart Association Scientific Sessions in Chicago and published at the same time in Circulation, according to ad-hoc-news.de. The trial compared starting treatment with a statin plus ezetimibe against starting with a statin alone in adults with established atherosclerotic cardiovascular disease. [1] It enrolled 3,048 participants at 17 centers in South Korea. [1]

The mean age of the cohort was 64.4 years, and 79.1 percent were men. Recruitment ran from January 2021 to July 2022, with a median follow-up of 3 years. [1]

## Design and LDL results

Patients were randomized to the combination (1,525) or to statin monotherapy (1,523). A second randomization set the LDL target at either below 55 mg/dL or below 70 mg/dL, and doses were adjusted according to the protocol. [1]

The combination lowered LDL cholesterol more than the statin alone. In the group with the target below 55 mg/dL, patients reached an average of 53 mg/dL on the combination versus 62 mg/dL on the statin alone. In the group with the target below 70 mg/dL, the averages were 63 mg/dL versus 70 mg/dL. [1]

## Clinical events and limitations

Despite the larger LDL reduction, the clinical events did not differ substantially between the strategies. The 3-year rate of the composite endpoint of cardiac death, myocardial infarction, stroke, revascularization and hospitalization for unstable angina was 8.5 percent with the combination and 7.9 percent with the statin alone. The difference was not statistically significant. Rates of myocardial infarction, stroke and other cardiovascular events were also similar in both arms. Adverse events occurred at a similar level in both groups. [1]

The report notes that the trial compared starting strategies rather than fixed regimens. In the monotherapy group, clinicians later added ezetimibe to reach the targets in more than 34 percent of patients with an LDL target below 55 mg/dL and in almost 25 percent of those with a target below 70 mg/dL. [1]

The authors point to several limitations. The cohort was too small to reliably detect minor clinical differences between the groups, and the 3-year follow-up was comparatively short. The study was open-label, and the population consisted mostly of male patients in South Korea. [1]

## Sources

1. [ad-hoc-news.de](https://www.ad-hoc-news.de/wissenschaft/ez-pave-studie-statin-plus-ezetimib-senkt-ldl-aber-ereignisse-bleiben-aehnlich/70476431)

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Source: RealTech, realtech.media — https://realtech.media/news/rt-3f79682c0f0d9eaf07a5f142_ez_pave_statin/