Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2018;71:423-31 - Vol. 71 Num.06 DOI: 10.1016/j.rec.2017.06.008

High-intensity Statin Treatments in Clinically Stable Patients on Aspirin Monotherapy 12 Months After Drug-eluting Stent Implantation: A Randomized Study

Eui Im a, Yun-Hyeong Cho b, Yongsung Suh b, Deok-Kyu Cho b, Ae-Young Her c, Yong Hoon Kim c, Kyounghoon Lee d, Woong Chol Kang d, Kyeong Ho Yun e, Sang-Yong Yoo f, Sang-Sig Cheong f, Dong-Ho Shin g, Chul-Min Ahn g, Jung-Sun Kim g,h, Byeong-Keuk Kim g,h, Young-Guk Ko g,h, Donghoon Choi g,h, Yangsoo Jang g,h,i, Myeong-Ki Hong g,h,i,

a Department of Internal Medicine, Yongin Severance Hospital, Yonsei University Health System, Yongin, Korea
b Department of Internal Medicine, Myongji Hospital, Goyang, Korea
c Department of Internal Medicine, School of Medicine, Kangwon National University, Chuncheon, Korea
d Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea
e Department of Internal Medicine, Wonkwang University Hospital, Iksan, Korea
f Department of Internal Medicine, GangNeung Asan Hospital, GangNeung, Korea
g Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University Health System, Seoul, Korea
h Cardiovascular Research Institute, Yonsei University College of Medicine, Seoul, Korea
i Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, Korea

Refers to

Should We Up the Intensity of Statin Therapy After Placing a Drug-eluting Stent?
Kinjan H. Parikh, Ajay J. Kirtane
Rev Esp Cardiol. 2018;71:416-7
Full text - PDF

Keywords

Coronary artery disease. Drug-eluting stent. Statin.

Abstract

Introduction and objectives

Current guidelines on the treatment of blood cholesterol recommend continuous maintenance of high-intensity statin treatment in drug-eluting stent (DES)-treated patients. However, high-intensity statin treatment is frequently underused in clinical practice after stabilization of DES-treated patients. Currently, the impact of continuous high-intensity statin treatment on the incidence of late adverse events in these patients is unknown. We investigated whether high-intensity statin treatment reduces late adverse events in clinically stable patients on aspirin monotherapy 12 months after DES implantation.

Methods

Clinically stable patients who underwent DES implantation 12 months previously and received aspirin monotherapy were randomly assigned to receive either high-intensity (40 mg atorvastatin, n = 1000) or low-intensity (20 mg pravastatin, n = 1000) statin treatment. The primary endpoint was adverse clinical events at 12-month follow-up (a composite of all death, myocardial infarction, revascularization, stent thrombosis, stroke, renal deterioration, intervention for peripheral artery disease, and admission for cardiac events).

Results

The primary endpoint at 12-month follow-up occurred in 25 patients (2.5%) receiving high-intensity statin treatment and in 40 patients (4.1%) receiving low-intensity statin treatment (HR, 0.58; 95%CI, 0.36-0.92; P = .018). This difference was mainly driven by a lower rate of cardiac death (0 vs 0.4%, P = .025) and nontarget vessel myocardial infarction (0.1 vs 0.7%, P = .033) in the high-intensity statin treatment group.

Conclusions

Among clinically stable DES-treated patients on aspirin monotherapy, high-intensity statin treatment significantly reduced late adverse events compared with low-intensity statin treatment.

Clinical trial registration: URL: http://www.clinicaltrials.gov. Unique identifier: NCT01557075.

1885-5857/© 2018 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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