Prevalence and Effects of High-Intensity Statins for Japanese Patients Presenting With Acute Coronary Syndromeã- A Post Hoc Secondary Analysis of STOPDAPT-2 ACS.
Circ J
; 87(5): 657-668, 2023 04 25.
Article
em En
| MEDLINE
| ID: mdl-36477579
ABSTRACT
BACKGROUND:
The REAL-CAD trial, reported in 2017, demonstrated a significant reduction in cardiovascular events with high-intensity statins in patients with chronic coronary syndrome. However, data are scarce on the use of high-intensity statins in Japanese patients with acute coronary syndrome (ACS).MethodsâandâResults:
In STOPDAPT-2 ACS, which exclusively enrolled ACS patients between March 2018 and June 2020, 1,321 (44.2%) patients received high-intensity statins at discharge, whereas of the remaining 1,667 patients, 96.0% were treated with low-dose statins. High-intensity statins were defined as the maximum approved doses of strong statins in Japan. The incidence of the cardiovascular composite endpoint (cardiovascular death, myocardial infarction, definite stent thrombosis, stroke) was significantly lower in patients with than without high-intensity statins (1.44% vs. 2.69% [log-rank P=0.025]; adjusted hazard ratio [aHR] 0.48, 95% confidence interval [CI] 0.24-0.94, P=0.03) and the effect was evident beyond 60 days after the index percutaneous coronary intervention (log-rank P=0.01; aHR 0.38, 95% CI 0.17-0.86, P=0.02). As for the bleeding endpoint, there was no significant difference between the 2 groups (0.99% vs. 0.73% [log-rank P=0.43]; aHR 0.96, 95% CI 0.35-2.60, P=0.93).CONCLUSIONS:
The prevalence of high-intensity statins has increased substantially in Japan. The use of the higher doses of statins in ACS patients recommended in the guidelines was associated with a significantly lower risk of the primary cardiovascular composite endpoint compared with lower-dose statins.Palavras-chave
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Inibidores de Hidroximetilglutaril-CoA Redutases
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Síndrome Coronariana Aguda
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Intervenção Coronária Percutânea
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Infarto do Miocárdio
Tipo de estudo:
Prevalence_studies
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Risk_factors_studies
Limite:
Humans
Idioma:
En
Revista:
Circ J
Assunto da revista:
ANGIOLOGIA
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CARDIOLOGIA
Ano de publicação:
2023
Tipo de documento:
Article