Efficacy, safety and clinical outcome associated with statin use for primary prevention in Korean patients with low-density lipoprotein cholesterol level [greater than or equal to] 190 mg/dL: A retrospective cohort study

• Published in: PLoS ONE 2023, Vol.18 (6), p.e0280586
• Main Authors: Kim, Hack-Lyoung, Lim, Woo-Hyun, Seo, Jae-Bin, Zo, Joo-Hee, Kim, Myung-A, Kim, Sang-Hyun
• Format: Report
• Language: English
• Subjects: Anticholesteremic agents; Antilipemic agents; Blood cholesterol; Cardiovascular agents; Cardiovascular diseases; Low density lipoproteins; Patient outcomes; Prevention; Rankings
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0280586

Although the current guideline recommends the use of high-intensity statin to reduce the low-density lipoprotein cholesterol (LDL-C) level by 50% in patients with baseline value of [greater than or equal to] 190 mg/dL, direct application of this recommendation to Asian populations is still questionable. This study was performed to investigate the statin response of LDL-C in Korean patients with LDL-C [greater than or equal to] 190 mg/dL. A total of 1,075 Korean patients (age 60.7 ± 12.2 years, women 68%) with baseline LDL-C [greater than or equal to] 190 mg/dL without cardiovascular disease was retrospectively reviewed. Lipid profiles at 6 months, side effects and clinical outcomes during the follow-up period after statin treatment were assessed according to statin intensity. Most of the patients (76.3%) were treated with moderate-intensity statins, 11.4% with high-intensity statins, and 12.3% with a statin + ezetimibe. The reductions in LDL-C percentage at 6 months were 48.0%, 56.0% and 53.3% in patients treated with moderate-intensity statins, high-intensity statins and statin + ezetimibe, respectively (P < 0.001). Side effects requiring dose reduction, medication switch or drug interruption were observed in 1.3%, 4.9% and 2.3% of patients treated with moderate-intensity statin, high-intensity statin and statin + ezetimibe, respectively (P = 0.024). During the median follow-duration of 815 days (interquartile range, 408-1,361 days), the incidences of cardiovascular events were not different among the 3 groups (log-rank P = 0.823). Compared to high-intensity statin, moderate-intensity statin was effective enough in reaching target goal of LDL-C without increase in cardiovascular risk and with fewer side effects in Korean patients with LDL-C [greater than or equal to] 190 mg/dL.