TY - JOUR
T1 - Low-Density Lipoprotein Cholesterol Levels on Statins and Cardiovascular Event Risk in Stable Coronary Artery Disease - An Observation From the REAL-CAD Study -
AU - Toyota, Toshiaki
AU - Morimoto, Takeshi
AU - Iimuro, Satoshi
AU - Fujita, Retsu
AU - Iwata, Hiroshi
AU - Miyauchi, Katsumi
AU - Inoue, Teruo
AU - Nakagawa, Yoshihisa
AU - Nishihata, Yosuke
AU - Daida, Hiroyuki
AU - Ozaki, Yukio
AU - Suwa, Satoru
AU - Sakuma, Ichiro
AU - Furukawa, Yutaka
AU - Shiomi, Hiroki
AU - Watanabe, Hirotoshi
AU - Yamaji, Kyohei
AU - Saito, Naritatsu
AU - Natsuaki, Masahiro
AU - Ohashi, Yasuo
AU - Matsuzaki, Masunori
AU - Nagai, Ryozo
AU - Kimura, Takeshi
N1 - Publisher Copyright:
© 2023 Japanese Circulation Society. All rights reserved.
PY - 2023
Y1 - 2023
N2 - Background: The relationship between very low on-treatment low-density lipoprotein cholesterol (LDL-C) level and cardiovascular event risk is still unclear in patients receiving the same doses of statins. Methods and Results: From the REAL-CAD study comparing high-dose (4 mg/day) with low-dose (1 mg/day) pitavastatin therapy in patients with stable coronary artery disease, 11,105 patients with acceptable statin adherence were divided into 3 groups according to the on-treatment LDL-C level at 6 months (<70 mg/dL, 70–100 mg/dL, and ≥100 mg/dL). The primary outcome measure was a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal ischemic stroke, or unstable angina requiring emergent admission. The adjusted risks of the LDL-C <70 mg/dL group relative to the LDL-C 70–100 mg/dL group (reference) was not significantly different for the primary outcome measure in both 1 mg/day and 4 mg/day strata (HR 0.84, 95% CI 0.58–1.18, P=0.32, and HR 1.25, 95% CI 0.88–1.79, P=0.22). The adjusted risk of the LDL-C ≥100 mg/dL group relative to the reference group was not significant for the primary outcome measure in the 1 mg/day stratum (HR 0.82, 95% CI 0.60–1.11, P=0.21), whereas it was highly significant in the 4 mg/day stratum (HR 3.32, 95% CI 2.08–5.17, P<0.001). Conclusions: A very low on-treatment LDL-C level (<70 mg/dL) was not associated with lower cardiovascular event risk compared with moderately low on-treatment LDL-C level (70–100 mg/dL) in patients receiving the same doses of statins.
AB - Background: The relationship between very low on-treatment low-density lipoprotein cholesterol (LDL-C) level and cardiovascular event risk is still unclear in patients receiving the same doses of statins. Methods and Results: From the REAL-CAD study comparing high-dose (4 mg/day) with low-dose (1 mg/day) pitavastatin therapy in patients with stable coronary artery disease, 11,105 patients with acceptable statin adherence were divided into 3 groups according to the on-treatment LDL-C level at 6 months (<70 mg/dL, 70–100 mg/dL, and ≥100 mg/dL). The primary outcome measure was a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal ischemic stroke, or unstable angina requiring emergent admission. The adjusted risks of the LDL-C <70 mg/dL group relative to the LDL-C 70–100 mg/dL group (reference) was not significantly different for the primary outcome measure in both 1 mg/day and 4 mg/day strata (HR 0.84, 95% CI 0.58–1.18, P=0.32, and HR 1.25, 95% CI 0.88–1.79, P=0.22). The adjusted risk of the LDL-C ≥100 mg/dL group relative to the reference group was not significant for the primary outcome measure in the 1 mg/day stratum (HR 0.82, 95% CI 0.60–1.11, P=0.21), whereas it was highly significant in the 4 mg/day stratum (HR 3.32, 95% CI 2.08–5.17, P<0.001). Conclusions: A very low on-treatment LDL-C level (<70 mg/dL) was not associated with lower cardiovascular event risk compared with moderately low on-treatment LDL-C level (70–100 mg/dL) in patients receiving the same doses of statins.
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U2 - 10.1253/circj.CJ-22-0127
DO - 10.1253/circj.CJ-22-0127
M3 - Article
C2 - 36002313
AN - SCOPUS:85147047686
SN - 1346-9843
VL - 87
SP - 360
EP - 367
JO - Circulation Journal
JF - Circulation Journal
IS - 2
ER -