Moderate-intensity versus high-intensity statin therapy in Korean patients with angina undergoing percutaneous coronary intervention with drug-eluting stents: A propensity-score matching analysis

• Published in: PloS one 2018-12, Vol.13 (12), p.e0207889-e0207889
• Main Authors: Park, Mahn-Won, Park, Gyung-Min, Han, Seungbong, Yang, Yujin, Kim, Yong-Giun, Roh, Jae-Hyung, Park, Hyun Woo, Suh, Jon, Cho, Young-Rak, Won, Ki-Bum, Ann, Soe Hee, Kim, Shin-Jae, Kim, Dae-Won, Her, Sung Ho, Lee, Sang-Gon
• Format: Article
• Language: English
• Subjects: Acute coronary syndromes; Aged; Angina; Angina pectoris; Angina Pectoris - therapy; Angioplasty; Antilipemic agents; Atherosclerosis; Balloon angioplasty; Cardiac patients; Cardiology; Cardiovascular agents; Cardiovascular disease; Care and treatment; Cholesterol; Clinical outcomes; Comorbidity; Comparative analysis; Confidence intervals; Coronary artery; Coronary artery disease; Coronary Artery Disease - complications; Coronary Artery Disease - therapy; Coronary heart disease; Coronary vessels; Diabetes; Dosage and administration; Dose-Response Relationship, Drug; Drug delivery; Drug dosages; Drug-Eluting Stents; Female; Health aspects; Heart attack; Heart attacks; Heart diseases; Hospitals; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage; Implants; Insurance; Intervention; Low density lipoprotein; Male; Matching; Medical research; Medicine; Medicine and Health Sciences; Middle Aged; Myocardial infarction; Myocardial Infarction - etiology; Myocardial Infarction - prevention & control; National health insurance; Patient outcomes; Patients; Percutaneous Coronary Intervention; Propensity Score; Proportional Hazards Models; Republic of Korea; Retirement benefits; Statins; Stents; Therapy; Treatment Outcome; Ultrasonic imaging
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0207889

It is unclear whether high-intensity statin therapy provides incremental clinical benefits over moderate-intensity statin therapy in Asian patients with angina. This study sought to compare the clinical outcomes of moderate- and high-intensity statin therapies in patients undergoing percutaneous coronary intervention (PCI) for angina in Korean patients. Based on the national health insurance claims data in South Korea, patients aged 18 years or older without a known history of coronary artery disease, who underwent PCI with drug-eluting stents due to angina between 2011 and 2015, were enrolled. According to the intensity of statin therapy, patients were categorized into moderate-intensity statin therapy (n = 23,863) and high-intensity statin therapy (n = 9,073) groups. The primary endpoint, defined as a composite of all-cause death and myocardial infarction, was compared between the two groups using a propensity-score matching analysis. During the follow-up period (median, 2.0 years; interquartile range, 1.1-3.1), 1,572 patients had 1,367 deaths and 242 myocardial infarctions. After propensity-score matching, there were 8,939 matched pairs. There was no significant difference in the incidence of the primary endpoint between the two groups (adjusted hazard ratio of high-intensity statin therapy, 1.093; 95% confidence interval: 0.950-1.259; p = 0.212). In Korean patients undergoing PCI with drug-eluting stents for angina, the high-intensity statin therapy did not provide additional clinical benefits over the moderate-intensity statin therapy.