Adding ezetimibe to a statin lowers cholesterol several times more than doubling the statin dose. In people who have artery or kidney disease the pairing prevents some heart attacks, strokes and procedures; whether anyone lives longer remains disputed. A moderate statin plus ezetimibe produces fewer dose reductions and abandonments than a maximal statin alone, at equal protection. (Full Review)
| Marker | Target | Why |
|---|---|---|
| LDL cholesterol | Below 70 mg/dL with plaque, 100 mg/dL otherwise; many specialists target 55 mg/dL after an event | The primary target the combination exists to move |
| Apolipoprotein B | Below 80 mg/dL; 60 mg/dL with plaque | Counts artery-damaging particles, not the cholesterol inside them |
| Lipoprotein(a) | Below 30 mg/dL, equivalently below 75 nmol/L | Largely unmoved by this combination, so it reframes residual risk |
| Non-HDL cholesterol | Below 100 mg/dL; 85 mg/dL with plaque | Captures every artery-damaging particle when triglycerides are high |
| Triglycerides | Below 100 mg/dL | Contextualises LDL; flags insulin resistance |
| ALT and AST | ALT below 25 U/L in men, below 20 U/L in women | Transaminase rise both components can cause |
| Creatine kinase | No established target; track against own pre-treatment value | Separates statin myopathy from unrelated aches |
| HbA1c | 4.8% to 5.4% | The statin component's modest push toward type 2 diabetes |
| hs-CRP | Below 1.0 mg/L | Residual inflammatory risk after LDL is lowered, which the statin only partly reduces |
| TSH | 0.5 to 2.5 mIU/L | Undertreated hypothyroidism raises LDL and predisposes to muscle symptoms |
| eGFR and creatinine | eGFR above 90 mL/min/1.73 m² | Sets the rosuvastatin dose ceiling and contextualises the kidney-disease evidence |
| 25-hydroxyvitamin D | 40 to 60 ng/mL | Low levels track with reported statin muscle complaints |
Cadence: Lipids and liver enzymes at 4 to 12 weeks and after every dose change, then every 6 to 12 months once the target holds. HbA1c annually, twice yearly where fasting glucose is already prediabetic. Creatine kinase only when muscle symptoms appear. Lipoprotein(a) once in a lifetime.