A combination of a high-dose statin and another anti-lipid medication can significantly lower the risk of death in people who have experienced a heart attack or unstable angina, researchers said in a study released on Wednesday.

The study has found that people who had a heart attack or unstable angina were 47 per cent less likely to die within three years if they start taking a high-dose statin and the drug called ezetimibe compared with those taking only a high-dose statin.

Both statins and ezetimibe are widely available drugs that have been found to be effective in reducing cholesterol levels in the blood. High cholesterol can lead to blockages in blood vessels, raising the risk of heart disease, stroke, or peripheral artery disease.

In the study, Maciej Banach, professor of cardiology at the Medical University of Lodz, Poland, and colleagues in other institutions examined data from 1,536 patients with acute coronary syndrome — including people who have had heart attacks or unstable angina. Half of these patients had received high-dose statin only, the other half had received the combination.

Their results, published on Wednesday in the Journal of the American Heart Association, show that those who started a statin and ezetimibe straight away were less likely to die from any cause over the next three years. The lower risk of death was apparent after only 52 days of treatment.

“Patients with acute coronary syndrome such as those who have already had a heart attack face a much higher risk of further heart problems,” Banach said in a media release. “Current guidelines, including those on prevention from the European Society of Cardiology, recommend a stepwise approach, first offering a statin only. This study shows that if we act quickly and decisively to lower patients’ cholesterol with this combination, we can (significantly) reduce the risk of death.”

Cardiologists in India who have reviewed clinical research on the use of ezetimibe alongside statins have said the combination is “safe and well-tolerated” as a result of different mechanisms of action in the body.

“The drug has now found widespread acceptability as an add-on therapy and the latest guidelines recommend adding ezetimibe if the cholesterol targets are not met with statins and there is residual cardiovascular risk,” Monica Bhandari, a cardiologist at the King George Medical College, Lucknow, and her colleagues had said in a medical review of ezetimibe three years ago.

The new findings by Banach suggest that starting with the combination would be better than waiting to see if statins alone can lower the cholesterol to desired levels.