| 제목 | Moderate-Intensity Statins Plus Ezetimibe vs. High-Intensity Statins After Coronary Revascularization: A Cohort Study | ||
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| 작성자 | 관리자 | 등록일 | 2022-07-13 |
내용
Moderate-Intensity Statins Plus Ezetimibe vs. High-Intensity Statins After Coronary Revascularization: A Cohort Study
Juwon Kim # 1, Danbee Kang # 2 3, Hyejeong Park 2, Minwoong Kang 2 3, Ki Hong Choi 1, Taek Kyu Park 1, Joo Myung Lee 1, Jeong Hoon Yang 1, Young Bin Song 1, Jin-Ho Choi 1, Seung-Hyuk Choi 1, Hyeon-Cheol Gwon 1, Eliseo Guallar 2 3 4, Juhee Cho 5 6, Joo-Yong Hahn 7
Affiliations expand
- PMID: 34533691
- DOI: 10.1007/s10557-021-07256-1
Abstract
Purpose: Whether moderate-intensity statins plus ezetimibe could be an alternative to high-intensity statins in patients with atherosclerotic cardiovascular disease is unclear. We compared the risk of adverse cardiovascular events in patients receiving moderate-intensity statins plus ezetimibe vs. high-intensity statins after a coronary revascularization procedure using data from a large cohort study.
Method: Population-based cohort study using nationwide medical insurance data from Korea. Study participants (n = 20,070) underwent percutaneous coronary intervention or coronary artery bypass graft surgery between January 1, 2015, and December 31, 2016, and received moderate-intensity statins (atorvastatin 10-20 mg or rosuvastatin 5-10 mg) plus ezetimibe (n = 922) or high-intensity statins (atorvastatin 40-80 mg or rosuvastatin 20 mg; n = 19,148). The primary outcome was a composite of cardiovascular mortality, hospitalization for myocardial infarction (MI), hospitalization for stroke, or revascularization.
Results: At 12 months, the incidence rates of the primary outcome were 138.0 vs. 154.0 per 1000 person-years in the moderate-intensity stains plus ezetimibe and the high-intensity statins group, respectively. The fully adjusted hazard ratio [HR] for the primary outcome was 1.11 (95% confidence interval [CI] 0.86-1.42; p = 0.43). The multivariable-adjusted HR for a composite of cardiovascular mortality, hospitalization for MI, or hospitalization for stroke was 1.05 (95% CI 0.74-1.47; p = 0.80). During follow-up, the proportion of patients maintaining their initial lipid-lowering therapy was significantly higher in the moderate-intensity statins plus ezetimibe group than in the high-intensity statins group.
Conclusions: Patients undergoing a coronary revascularization procedure who received moderate-intensity statins plus ezetimibe showed similar rates of major adverse cardiovascular events as patients who received high-intensity statins.
Keywords: Coronary artery bypass graft surgery; Ezetimibe; Percutaneous coronary intervention; Secondary prevention; Statin.
