Of the two components of vytorin, simvastatin
has clearly been shown to decrease the rate of death, myocardial infarction and stroke, in over 40,000 patients. It is probably the best studied statin, and I have no problems prescribing it. Ezetimibe has been shown to decrease LDL cholesterol, but there is no Life
saving data in the published literature. So it depends if you think that LDL lowering automatically improves mortality independent of the mechanism or not.