BACKGROUND: Association of the type of statin and the achieved level of low-density lipoprotein cholesterol (LDL-C) with cardiovascular outcome has not been fully elucidated. METHODS AND RESULTS: The study included 14,866 patients who underwent a first coronary revascularization in 2005-2007. We identified 7,299 patients with statin therapy at discharge (so-called strong statins [atorvastatin, rosuvastatin, and pitavastatin]: 4,742 patients; standard statins [pravastatin, simvastatin, and fluvastatin]: 2,557 patients). Unadjusted 3-year incidence of major adverse cardiovascular events (MACE: composite of cardiovascular death, myocardial infarction and stroke) was significantly lower (7.5% vs. 9.6%, P=0.0008) in the strong statin group, and there was a trend in adjusted risk of MACE favoring strong statins (hazard ratio [HR] 0.87, [95% confidence interval (CI) 0.73-1.04], P=0.13). Among 4,846 patients with follow-up LDL-C data available, outcomes were evaluated according to achieved LDL-C level (<80, 80-99 [reference], 100-119, ≥120 mg/dl). Compared with the reference group, the risk for MACE was significantly higher in the ≥120 mg/dl group (adjusted HR 1.74 [95%CI 1.11-2.71], P=0.01), although it was comparable in the 100-119 mg/dl group (adjusted HR 1.23 [95%CI 0.78-1.94], P=0.38) and in the <80 mg/dl group (adjusted HR 1.15 [95%CI 0.75-1.75], P=0.52). CONCLUSIONS: Strong statin therapy was associated with a trend toward lower cardiovascular risk compared with standard statin therapy. When LDL-C <120 mg/dl was achieved, risks for cardiovascular events were comparable irrespective of achieved LDL-C level.
BACKGROUND: Association of the type of statin and the achieved level of low-density lipoprotein cholesterol (LDL-C) with cardiovascular outcome has not been fully elucidated. METHODS AND RESULTS: The study included 14,866 patients who underwent a first coronary revascularization in 2005-2007. We identified 7,299 patients with statin therapy at discharge (so-called strong statins [atorvastatin, rosuvastatin, and pitavastatin]: 4,742 patients; standard statins [pravastatin, simvastatin, and fluvastatin]: 2,557 patients). Unadjusted 3-year incidence of major adverse cardiovascular events (MACE: composite of cardiovascular death, myocardial infarction and stroke) was significantly lower (7.5% vs. 9.6%, P=0.0008) in the strong statin group, and there was a trend in adjusted risk of MACE favoring strong statins (hazard ratio [HR] 0.87, [95% confidence interval (CI) 0.73-1.04], P=0.13). Among 4,846 patients with follow-up LDL-C data available, outcomes were evaluated according to achieved LDL-C level (<80, 80-99 [reference], 100-119, ≥120 mg/dl). Compared with the reference group, the risk for MACE was significantly higher in the ≥120 mg/dl group (adjusted HR 1.74 [95%CI 1.11-2.71], P=0.01), although it was comparable in the 100-119 mg/dl group (adjusted HR 1.23 [95%CI 0.78-1.94], P=0.38) and in the <80 mg/dl group (adjusted HR 1.15 [95%CI 0.75-1.75], P=0.52). CONCLUSIONS: Strong statin therapy was associated with a trend toward lower cardiovascular risk compared with standard statin therapy. When LDL-C <120 mg/dl was achieved, risks for cardiovascular events were comparable irrespective of achieved LDL-C level.
Authors: Doo Sun Sim; Myung Ho Jeong; Hyo Soo Kim; Hyeon Cheol Gwon; Ki Bae Seung; Seung Woon Rha; Shung Chull Chae; Chong Jin Kim; Kwang Soo Cha; Jong Seon Park; Jung Han Yoon; Jei Keon Chae; Seung Jae Joo; Dong Ju Choi; Seung Ho Hur; In Whan Seong; Myeong Chan Cho; Doo Il Kim; Seok Kyu Oh; Tae Hoon Ahn; Jin Yong Hwang Journal: J Lipid Atheroscler Date: 2019-07-02
Authors: Young Joon Hong; Myung Ho Jeong; Jang Ho Bae; Seok Kyu Oh; Seung Woon Rha; Seung Ho Hur; Sung Yun Lee; Sang Wook Kim; Kwang Soo Cha; In Ho Chae; Tae Hoon Ahn; Kee Sik Kim Journal: Korean J Intern Med Date: 2017-06-16 Impact factor: 2.884