Abstract 14116: Effects of Statin Intensity and Low-density Lipoprotein Cholesterol Lowering in Korean Patients With Chronic Ischemic Heart Disease and Very Low Low-density Lipoprotein Cholesterol

Introduction: Current guidelines on lipid management emphasize LDL-C lowering >50% of baseline levels with intensive statin regimens in patients with coronary artery disease. However, whether this strategy is beneficial also in patients with very low LDL-C has not been proven. Furthermore, controversy remains on the optimal statin intensity for Asians in whom outcome data of lipid therapy are highly limited. Methods and Results: Totally, 3867 patients with chronic ischemic heart disease were initially screened. Among them, 393 subjects(age: 66 years; males: 68%) who showed baseline LDL-C During the mean follow-up of 3.8 years, 41 patients (10.4%) experienced MACE. The event-free survival was higher in patients receiving higher dose statins (Figure, p=0.03). In the univariate analysis, age (p=0.05), the % change of LDL-C (p=0.01), and the statin intensity (p=0.03) were associated with MACE. In the multivariate analysis, the statin intensity was found to be an only independent predictor of clinical outcome (p=0.05). Interestingly, the beneficial effect of statins became significant at the moderate-high dose. The predictive value of the % change of LDL-C was not significant after controlling other variables. Conclusions: Our study demonstrated that higher dose statins (at least moderate-high intensity) were more beneficial in Asian patients with chronic ischemic heart disease even if their LDL-C is