TY - JOUR
T1 - High-Density Lipoprotein Cholesterol and Cardiovascular Events in Patients with Stable Coronary Artery Disease Treated with Statins
T2 - An Observation from the REAL-CAD Study
AU - on behalf of the REAL-CAD study investigators
AU - Omote, Kazunori
AU - Yokota, Isao
AU - Nagai, Toshiyuki
AU - Sakuma, Ichiro
AU - Nakagawa, Yoshihisa
AU - Kamiya, Kiwamu
AU - Iwata, Hiroshi
AU - Miyauchi, Katsumi
AU - Ozaki, Yukio
AU - Hibi, Kiyoshi
AU - Hiro, Takafumi
AU - Fukumoto, Yoshihiro
AU - Mori, Hiroyoshi
AU - Hokimoto, Seiji
AU - Ohashi, Yasuo
AU - Ohtsu, Hiroshi
AU - Ogawa, Hisao
AU - Daida, Hiroyuki
AU - Iimuro, Satoshi
AU - Shimokawa, Hiroaki
AU - Saito, Yasushi
AU - Kimura, Takeshi
AU - Matsuzaki, Masunori
AU - Nagai, Ryozo
AU - Anzai, Toshihisa
N1 - Publisher Copyright:
© 2022 Japan Atherosclerosis Society.
PY - 2022
Y1 - 2022
N2 - Aim: The association between high-density lipoprotein cholesterol (HDL-C) level after statin therapy and cardiovascular events in patients with stable coronary artery disease (CAD) remains unclear. Thus, in this study, we sought to determine how HDL-C level after statin therapy is associated with cardiovascular events in stable CAD patients. Methods: From the REAL-CAD study which had shown the favorable prognostic effect of high-dose pitavastatin in stable CAD patients with low-density lipoprotein cholesterol (LDL-C) <120 mg/dL, 9,221 patients with HDL-C data at baseline and 6 months, no occurrence of primary outcome at 6 months, and reported non-adherence for pitavastatin, were examined. The primary outcome was a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal ischemic stroke, or unstable angina requiring emergent admission after 6 months of randomization. Absolute difference and ratio of HDL-C levels were defined as (those at 6 months–at baseline) and (absolute difference/baseline)×100, respectively. Results: During a median follow-up period of 4.0 (IQR 3.2–4.7) years, the primary outcome occurred in 417 (4.5%) patients. The adjusted risk of all HDL-C-related variables (baseline value, 6-month value, absolute, and relative changes) for the primary outcome was not significant (hazard ratio [HR] 0.99, 95% confidence interval [CI] 0.91–1.08, HR 1.03, 95% CI 0.94–1.12, HR 1.05, 95% CI 0.98–1.12, and HR 1.08, 95% CI 0.94–1.24, respectively). Furthermore, adjusted HRs of all HDL-C-related variables remained non-significant for the primary outcome regardless of on-treatment LDL-C level at 6 months. Conclusions: After statin therapy with modestly controlled LDL-C, HDL-C level has little prognostic value in patients with stable CAD.
AB - Aim: The association between high-density lipoprotein cholesterol (HDL-C) level after statin therapy and cardiovascular events in patients with stable coronary artery disease (CAD) remains unclear. Thus, in this study, we sought to determine how HDL-C level after statin therapy is associated with cardiovascular events in stable CAD patients. Methods: From the REAL-CAD study which had shown the favorable prognostic effect of high-dose pitavastatin in stable CAD patients with low-density lipoprotein cholesterol (LDL-C) <120 mg/dL, 9,221 patients with HDL-C data at baseline and 6 months, no occurrence of primary outcome at 6 months, and reported non-adherence for pitavastatin, were examined. The primary outcome was a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal ischemic stroke, or unstable angina requiring emergent admission after 6 months of randomization. Absolute difference and ratio of HDL-C levels were defined as (those at 6 months–at baseline) and (absolute difference/baseline)×100, respectively. Results: During a median follow-up period of 4.0 (IQR 3.2–4.7) years, the primary outcome occurred in 417 (4.5%) patients. The adjusted risk of all HDL-C-related variables (baseline value, 6-month value, absolute, and relative changes) for the primary outcome was not significant (hazard ratio [HR] 0.99, 95% confidence interval [CI] 0.91–1.08, HR 1.03, 95% CI 0.94–1.12, HR 1.05, 95% CI 0.98–1.12, and HR 1.08, 95% CI 0.94–1.24, respectively). Furthermore, adjusted HRs of all HDL-C-related variables remained non-significant for the primary outcome regardless of on-treatment LDL-C level at 6 months. Conclusions: After statin therapy with modestly controlled LDL-C, HDL-C level has little prognostic value in patients with stable CAD.
KW - High-density lipoprotein cholesterol
KW - Lipids
KW - Secondary prevention
KW - Stable coronary artery disease
KW - Statin
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U2 - 10.5551/jat.59881
DO - 10.5551/jat.59881
M3 - Article
C2 - 33431716
AN - SCOPUS:85123325471
SN - 1340-3478
VL - 29
SP - 50
EP - 68
JO - Journal of atherosclerosis and thrombosis
JF - Journal of atherosclerosis and thrombosis
IS - 1
ER -