Tratamiento de alta intensidad con estatinas para pacientes estables en monoterapia con ácido acetilsalicílico a los 12 meses de un implante de stent farmacoactivo: estudio aleatorizado

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

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

Research output: Contribution to journalArticle

7 Citations (Scopus)

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. Full English text available from: www.revespcardiol.org/en

Translated title of the contributionHigh-intensity Statin Treatments in Clinically Stable Patients on Aspirin Monotherapy 12 Months After Drug-eluting Stent Implantation: A Randomized Study
Original languageSpanish
Pages (from-to)423-431
Number of pages9
JournalRevista Espanola de Cardiologia
Volume71
Issue number6
DOIs
Publication statusPublished - 2018 Jun

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

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    Im, E., Cho, Y. H., Suh, Y., Cho, D. K., Her, A. Y., Kim, Y. H., Lee, K., Kang, W. C., Yun, K. H., Yoo, S. Y., Cheong, S. S., Shin, D. H., Ahn, C. M., Kim, J. S., Kim, B. K., Ko, Y. G., Choi, D., Jang, Y., & Hong, M. K. (2018). Tratamiento de alta intensidad con estatinas para pacientes estables en monoterapia con ácido acetilsalicílico a los 12 meses de un implante de stent farmacoactivo: estudio aleatorizado. Revista Espanola de Cardiologia, 71(6), 423-431. https://doi.org/10.1016/j.recesp.2017.05.028