Ez-PAVE Study: Statin plus Ezetimib Lowers LDL to 53 Instead of 62 mg/dL

The Ez-PAVE study presented new findings at the AHA Scientific Sessions 2026 in Chicago, comparing a combined lipid-lowering therapy to monotherapy. The study, published in the journal Circulation, provides insights into the relationship between achieved cholesterol reduction and clinical event rates in patients at cardiovascular risk.

The study included 3,048 adults with atherosclerotic cardiovascular disease recruited from 17 centers in South Korea between January 2021 and July 2022. The average age of participants was 64.4 years, with 79.1% being male.

With a median follow-up of 3 years, the study examined 1,525 participants on a combination of statin and ezetimibe compared to 1,523 participants on statin monotherapy. After 3 years, a significant difference was observed in predefined LDL target levels. Patients on combination therapy achieved an average of 53 mg/dL at a target of under 55 mg/dL, compared to 62 mg/dL in the statin monotherapy group. For the target of under 70 mg/dL, the values were 63 mg/dL for the combination and 70 mg/dL for monotherapy.

Despite the greater LDL reduction with statin plus ezetimibe, there was no significant difference in hard clinical endpoints. The rate of cardiovascular events—defined as cardiovascular death, heart attack, stroke, revascularization, or hospitalization due to unstable angina—was 8.5% in the combination group versus 7.9% in the statin-only group.

Both treatment arms showed similar side effects. However, ezetimibe was later added to a portion of the monotherapy group, affecting over 34% of participants aiming for the target under 55 mg/dL and about 25% in the group with the target under 70 mg/dL.