Lipid lowering has become a core strategy in the prevention and treatment of atherosclerotic cardiovascular disease, and statins are considered the cornerstone of dyslipidemia and antiatherosclerotic drug therapy. However, the results of China’s second Lipid Therapy Status Study showed that the attainment rate for hypercholesterolemic patients treated with stable doses of statins was low, and especially serious was the attainment rate for high-risk and very high-risk patients of only 39% and 23%, respectively. The reasons for this include the failure of many patients to achieve cholesterol levels below target after receiving higher doses of statin therapy and the inability of some patients to tolerate statin therapy for a variety of reasons (abnormal liver function, elevated creatine kinase, myalgia, and rhabdomyolysis). ESC/EAS recommends that patients who cannot tolerate statin therapy may choose cholesterol absorption inhibitors alone or in combination with bile acid binding agents and niacin (IIb/c). Ezetimibe and niacin Ezetimibe is a new class of cholesterol-lowering drug that is a selective cholesterol absorption inhibitor, primarily blocking the exogenous absorption pathway of cholesterol. It inhibits the absorption of cholesterol in the intestine by acting on cholesterol transport proteins. Moreover, ezetimibe is hardly metabolized by cytochrome P450 enzymes and does not affect the concentration of statins, and no clinically significant drug-drug interactions occur between the two drugs in combination. The ENHANCE [4] study enrolled 720 patients with familial hypercholesterolemia and aimed to compare the mean change in carotid intima-media thickness (IMT) after treatment with ezetimibe/simvastatin versus high-dose simvastatin alone in patients with familial hypercholesterolemia. However, the results of the trial showed no significant difference in carotid intima-media thickness, although ezetimibe combined with simvastatin significantly reduced LDL-C and C-reactive protein levels compared with simvastatin alone. However, ezetimibe has now been confirmed by large clinical trials such as SEAS [5], ARBITER-6 , SHARP and the forthcoming results IMPROVE IT [6] to reduce LDL-c by 17.2% with ezetimibe alone and further reduce LDL cholesterol by 16.5% with the addition of ezetimibe to statin, and enable to reduce The safety and tolerability of ezetimibe monotherapy was comparable to that of placebo, and the safety and tolerability of combined statin therapy was comparable to that of statin alone. Although the SEAS showed a potential increase in cancer, a clinical meta-analysis showed that it did not increase cancer incidence. While niacin may lower LDL-c and has been shown to reduce cardiovascular events in small clinical studies, the HPS2-THRIVE study published in 2013 involved 25,673 patients at high cardiovascular risk in 6 countries, with approximately 80% having a history of coronary artery disease, 1/3 having a history of cerebrovascular disease, and 1/3 having diabetes at baseline. After determining that all subjects tolerated the full dose of niacin during the washout period, the investigators randomized subjects to 2 g/d extended-release niacin + 40 mg of laropiprant to relieve facial flushing or placebo. The results of the study showed that its addition of niacin to statin therapy did not improve prognosis; its incidence of side effects (especially infection and bleeding) was much greater than expected, at 3%, and its incidence of myopathy was higher in the Chinese population than in other populations.