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Statin Therapy in HIGH-Risk Individuals with NORMal Coronary Arteries: The HIGH-NORM Study

Authors
 Kyeong-Hyeon Chun  ;  Jung Mi Park  ;  Chan Joo Lee  ;  Jaewon Oh  ;  Sungha Park  ;  Seok-Min Kang  ;  Sang-Hak Lee 
Citation
 JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS, Vol.29(7) : 1085-1094, 2022-07 
Journal Title
JOURNAL OF ATHEROSCLEROSIS AND THROMBOSIS
ISSN
 1340-3478 
Issue Date
2022-07
MeSH
Computed Tomography Angiography ; Coronary Artery Disease* / drug therapy ; Coronary Vessels / diagnostic imaging ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors* / therapeutic use ; Male ; Middle Aged ; Myocardial Infarction* ; Retrospective Studies ; Risk Factors ; Treatment Outcome
Keywords
Coronary artery disease ; Health care ; Hydroxymethylglutaryl-CoA reductase inhibitors ; Outcome assessment ; Risk factors
Abstract
Aims: Mismatches between the risk status of a patient and coronary imaging data can lead to conflicting strategies to prevent a cardiovascular event. We evaluated whether statin use was associated with cardiovascular benefit in high-risk individuals whose coronary computed tomography angiography (CCTA) results showed normal coronary arteries.

Methods: Among asymptomatic individuals whose CCTA showed normal or near normal coronary arteries, 3,389 persons with high- or very-high-risk status were included in this retrospective study. After 1:2 propensity score matching, 906 individuals (302 new statin users and 604 controls; mean age 61 years; male 58%) were analysed. The primary outcome variable was major adverse cardiovascular and cerebrovascular events (MACCEs) that consisted of cardiovascular death, nonfatal myocardial infarction, coronary revascularisation, and nonfatal ischemic stroke.

Results: At a median follow-up of 5.8 years, 20 statin users and 17 controls (7.4 and 5.6 events/1,000 person-year, respectively; hazard ratio [HR) 1.04; p=0.92) experienced MACCE. Kaplan-Meier curves showed similar MACCE rates in both groups (p=0.91). In separate analyses for persons with normal (p=0.29) or near normal coronary arteries (p=0.67), MACCE rates did not differ between the groups. Age (HR 1.04; p=0.044), male sex (HR 3.06, p=0.018), and smoking (HR 2.87, p=0.019) were independently associated with MACCEs. In subgroup analyses, no significant factors affected the relationship between statin use and MACCEs.

Conclusions: Statin use was not associated with cardiovascular risk reduction in high-risk persons with normal or near normal coronary arteries. More individualised lipid-lowering therapy may benefit this population.
Files in This Item:
T202202420.pdf Download
DOI
10.5551/jat.63004
Appears in Collections:
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
Chun, Kyeong Hyeon(전경현) ORCID logo https://orcid.org/0000-0002-7798-658X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/189415
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