Better Survival With Statin Administration After Revascularization Therapy in Japanese Patients With Coronary Artery Disease Perspectives From the CREDO-Kyoto Registry
Open accessAbstract
BACKGROUND: The importance of statins in cardiovascular prevention has been demonstrated in various patient subsets. This study aimed to evaluate the effects of statins on long-term outcomes of Japanese patients undergoing their first coronary revascularization. METHODS AND RESULTS: A total of 9,225 patients undergoing their first coronary revascularizations during 2000--2002 were divided into 2 groups according to the use of statins at discharge; patients with acute myocardial infarction were not included. Statins was administered to only 28.5% (n=2,630) of the patients. The median follow-up period was 3.5 years. Patients on statin therapy showed lower all-cause (5.2% vs 10.0%; p<0.0001) and cardiovascular (3.2% vs 6.2%; p<0.0001) mortality than those without statins (n=6,595) by Kaplan-Meier analysis and log-rank test. After adjustment by multivariate analysis according to 29 variables, statin therapy remained as an independent predictor of reduced all-cause (relative risk ratio (RR) 0.71, 95% confidence interval (CI) 0.59-0.86, p=0.0005) and cardiovascular (RR 0.72, 95% CI 0.56-0.91, p=0.0067) mortality. The validity of RR of statin therapy in multivariate analysis was further confirmed by risk adjustment using propensity scores (all-cause mortality: propensity-adjusted RR 0.70, 95% CI 0.58-0.85, p=0.0003; cardiovascular mortality: propensity-adjusted RR 0.70, 95% CI 0.54-0.89, p=0.0038). CONCLUSIONS: Statin therapy started at hospital discharge was associated with increased chance of survival in Japanese patients undergoing their first coronary revascularization.
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In the JCAD and CREDO-Kyoto registry studies, the incidence rate of cardiovascular events was 15 per 1,000 person-years or higher in patients with CAD.
“the incidence rate of cardiovascular events was ≥ 15/1,000 person-years in the JCAD182) and CREDO-Kyoto studies183), which are registry studies involving patients with CAD.”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [182]
The JCAD observational study in Japan revealed that if three or more major risk factors are present, the risk for cardiovascular events is 1.3-fold higher compared to having two or fewer risk factors.
“JCAD observational study in Japan also revealed that if three or more major risk factors are present, the risk for cardiovascular events is 1.3-fold higher compared to having two or fewer risk factors182).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [182]
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- Authors
- Furukawa, Y., Taniguchi, R., Ehara, N., Ozasa, N., Haruna, Y., Saito, N., Doi, T., Hoshino, K., Shizuta, S., Morimoto, T., Imai, Y., Teramukai, S., Fukushima, M., Kita, T., Kimura, T., & CREDO-Kyoto Investigators
- Affiliations
- Kobe City Medical Center General Hospital (JP)
- Hyogo Prefectural Amagasaki General Medical Center (JP)
- Kyoto University Hospital (JP)
- Hirakata Kohsai Hospital (JP)
- Division of Cardiology, Nagai Hospital
- Kyoto University (JP)
- Translational Research Informatics Center
- University of Fukui (JP)
- ORCID
- Venue
- Circulation Journal
- Publisher
- Japanese Circulation Society
- Published
- 2008
- Volume
- 72
- Issue
- 12
- Pages
- 1937-1945
- ISSN
- 1346-9843 (ISSN-L)
- 1347-4820
- OpenAlex
- W2077837646
- Cited by
- 25
- References
- 37
- Citations by year
- 2023: 3 · 2019: 1 · 2018: 4 · 2016: 1 · 2013: 4 · 2012: 3
- FWCI
- 3.16
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation Journal (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Ministry of Health, Labour and Welfare
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Keywords
- statin therapy, coronary revascularization, coronary artery disease, all-cause mortality, cardiovascular mortality, long-term survival, Japanese patients, propensity score adjustment, CREDO-Kyoto registry
- MeSH terms
- Aged, Coronary Artery Bypass, Cardiovascular Diseases, Coronary Artery Disease, Female, Humans, Japan, Male, Patient Discharge, Registries, Retrospective Studies, Time Factors, Angioplasty, Balloon, Coronary, Multivariate Analysis, Proportional Hazards Models, Treatment Outcome, Risk Assessment, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Kaplan-Meier Estimate, Secondary Prevention
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