Impact of High-Intensity Statins and Low-Density Lipoprotein Cholesterol on the Outcomes of Coronary Intervention for Chronic Coronary Syndrome in Japan

AIM: The clinical effect of high-intensity statin therapy after percutaneous coronary intervention (PCI) in Japanese patients with chronic coronary syndrome (CCS) remains unclear. We investigated the association between high-intensity statin therapy and the cardiovascular outcomes following PCI in patients with CCS. METHODS: We retrospectively evaluated 716 patients with CCS who underwent PCI and categorized them into high- or non-high-intensity statin groups, according to the Japan Atherosclerosis Society guidelines. The primary outcome was a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, and revascularization, while the secondary outcome was all-cause death. The outcomes were further assessed according to the low-density lipoprotein cholesterol (LDL-C) levels (＜55 mg/dL, 55-69 mg/dL, and ≥ 70 mg/dL). The hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using the Cox model. RESULTS: Over a median follow-up of 2 years, high-intensity statin therapy reduced the incidence of the primary outcome (HR, 0.32; 95% CI, 0.17-0.61; P＜0.01) and all-cause death (HR, 0.18; 95% CI, 0.06-0.57; P＜0.01). This association with the primary composite outcome was consistently observed across the achieved LDL-C categories. CONCLUSIONS: High-intensity statin therapy was associated with a reduced risk of cardiovascular events after PCI in Japanese patients with CCS, independent of the achieved LDL-C levels.