The Impact of Pravastatin Therapy on Long-Term Outcome in Patients With Metabolic Syndrome Undergoing Complete Coronary Revascularization
Open accessAbstract
BACKGROUND: Few studies dealing with the efficacy of statin therapy among patients with metabolic syndrome (MS) and coronary artery disease (CAD) have been conducted. In particular, there have been no studies of the efficacy of statins among Asian MS patients with treated CAD. METHODS AND RESULTS: Data from 1,138 consecutive patients who underwent complete revascularization (coronary intervention or bypass surgery) were collected. Of these, 529 patients who satisfied the criteria for MS using the American Heart Association/National Heart, Lung and Blood Institute statement (body mass index >or=25 was used instead of waist circumference) were assessed. All-cause and cardiovascular mortality of patients given statins and those not given statins at least 2 weeks before the complete revascularization were compared. To adjust for the variables that would have been related to the decision to give statins, the propensity score was calculated, and multivariate Cox regression was carried out. Statins were given to 146 patients. During follow-up (9.1 +/-2.5 years), 104 patients died. On multivariate analysis, statin use was significantly associated with reduced all-cause (hazard ratio (HR) 0.56, 0.31-0.99; P=0.049) and cardiovascular (HR 0.53, 0.30-0.96; P=0.042) mortality. CONCLUSIONS: In patients with MS and CAD, statins given at least 2 weeks before the complete revascularization, was associated with a reduced risk of all-cause and cardiovascular mortality.
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In a sub-analysis of the TNT study of CAD patients complicated by metabolic syndrome, an overlap of the major risk factors poses a risk for cardiovascular events.
“A sub-analysis was performed with just those complicated by metabolic syndrome among all the subjects with CAD in the TNT study, and it was shown that an overlap of the major risk factors poses a risk for cardiovascular events.”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [776]
The incidence rate of cardiovascular events is particularly high in cases where three or more major risk factors are present.
“The incidence rate of cardiovascular events is particularly high in cases where three or more major risk factors are present.”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [776]
In the TNT sub-analysis, cardiovascular events are significantly suppressed by 29% with high-dose statin therapy compared to usual-dose statin therapy.
“However, it has been shown that cardiovascular event is significantly suppressed by 29% with high-dose statin therapy compared to a usual-dose statin therapy776).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [776]
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Kinoshita, M., Yokote, K., Arai, H., Iida, M., Ishigaki, Y., Ishibashi, S., Umemoto, S., Egusa, G., Ohmura, H., Okamura, T., et al. (2018) · Journal of Atherosclerosis and Thrombosis · doi:10.5551/jat.gl2017 · Cited by 813 · see citing works
Self-citation
- Authors
- Kasai, T., Miyauchi, K., Kajimoto, K., Kubota, N., Kurata, T., Amano, A., & Daida, H.
- Affiliations
- Juntendo University (JP)
- Venue
- Circulation Journal
- Publisher
- Japanese Circulation Society
- Published
- 2009
- Volume
- 73
- Issue
- 11
- Pages
- 2104-2109
- ISSN
- 1346-9843 (ISSN-L)
- 1347-4820
- OpenAlex
- W2089875707
- Cited by
- 13
- References
- 34
- Citations by year
- 2024: 1 · 2018: 2 · 2016: 1 · 2015: 1 · 2014: 1 · 2013: 1 · 2012: 2
- FWCI
- 2.02
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation Journal (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- pravastatin, statin therapy, metabolic syndrome, coronary artery disease, complete coronary revascularization, coronary artery bypass grafting, percutaneous coronary intervention, all-cause mortality, cardiovascular mortality, Asian patients, propensity score
- MeSH terms
- Aged, Coronary Artery Disease, Female, Humans, Japan, Male, Middle Aged, Myocardial Revascularization, Risk Factors, Time Factors, Proportional Hazards Models, Treatment Outcome, Pravastatin, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Metabolic Syndrome, Asian People, Kaplan-Meier Estimate
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