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Escalation of liPid-lOwering therapy in patientS wiTh vascular disease receiving HIGH-intensity statins: the retrospective POST-HIGH study

 Jaehyung Ha  ;  Bom Lee  ;  Jung Mi Park  ;  Moonjong Kang  ;  Jaewon Oh  ;  Chan Joo Lee  ;  Sungha Park  ;  Seok-Min Kang  ;  Sang-Hak Lee 
 SCIENTIFIC REPORTS, Vol.11(1) : 8884, 2021-04 
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In this retrospective study, we investigated whether lipid-lowering therapy (LLT) escalation has clinical benefits in patients with atherosclerotic cardiovascular disease (ASCVD) and low-density lipoprotein cholesterol (LDL-C) levels of 55-99 mg/dL (1.4-2.6 mmol/L), post high-intensity. Out of 6317 Korean patients screened in 2005-2018, 1159 individuals with ASCVD and LDL-C levels of 55-99 mg/dL after statin use equivalent to 40 mg atorvastatin were included. After 1:2 propensity score matching, 492 patients (164 with LLT escalation, 328 controls without LLT escalation) were finally analysed. Primary outcome variables were major adverse cardiovascular and cerebrovascular events (MACCE) and all-cause death. At median follow-up (1.93 years), the escalation group had a lower MACCE rate (1.72 vs. 3.38 events/100 person-years; hazard ratio [HR] 0.34, 95% confidence interval [CI] 0.14-0.83; p = 0.018) than the control group. The incidence of all-cause death (0.86 vs. 1.02 events/100 person-years; HR 0.58, 95% CI 0.15-2.19; p = 0.42) and each MACCE component did not differ between groups. Kaplan-Meier curves exhibited lower risk of MACCE in the escalation group (HR 0.36, 95% CI 0.12-0.97; p = 0.040) but a difference not statistically significant in all-cause death (HR 0.30, 95% CI 0.04-2.48; p = 0.26). LLT escalation was associated with reduced cardiovascular risk, supporting more aggressive LLT in this population.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kang, Seok Min(강석민) ORCID logo https://orcid.org/0000-0001-9856-9227
Park, Sung Ha(박성하) ORCID logo https://orcid.org/0000-0001-5362-478X
Oh, Jae Won(오재원) ORCID logo https://orcid.org/0000-0002-4585-1488
Lee, Sang Hak(이상학) ORCID logo https://orcid.org/0000-0002-4535-3745
Lee, Chan Joo(이찬주) ORCID logo https://orcid.org/0000-0002-8756-409X
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