1. High-intensity Statin Treatments in Clinically Stable Patients on Aspirin Monotherapy 12 Months After Drug-eluting Stent Implantation: A Randomized Study.
- Author
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Im E, Cho YH, Suh Y, Cho DK, Her AY, Kim YH, Lee K, Kang WC, Yun KH, Yoo SY, Cheong SS, Shin DH, Ahn CM, Kim JS, Kim BK, Ko YG, Choi D, Jang Y, and Hong MK
- Subjects
- Aspirin therapeutic use, Atorvastatin administration & dosage, Coronary Artery Disease mortality, Female, Graft Occlusion, Vascular etiology, Graft Occlusion, Vascular mortality, Humans, Male, Middle Aged, Myocardial Infarction etiology, Myocardial Infarction mortality, Myocardial Revascularization mortality, Myocardial Revascularization statistics & numerical data, Platelet Aggregation Inhibitors therapeutic use, Pravastatin administration & dosage, Stroke etiology, Stroke mortality, Treatment Outcome, Coronary Artery Disease prevention & control, Drug-Eluting Stents, Hydroxymethylglutaryl-CoA Reductase Inhibitors administration & dosage
- 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 (40mg atorvastatin, n = 1000) or low-intensity (20mg 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., (Copyright © 2017 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved.)
- Published
- 2018
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