Abstract 5618: Statins Reduce Angiographical Restenosis As Well As De Novo Lesions Causing Unstable Angina in Japanese Patients Underwent Percutaneous Coronary Intervention
Background With the introduction of drug-eluting stents (DES), restenosis and target-vessel revascularization could be reduced to rates below 10%. After resolution of the restenosis issue, cardiovascular events after DES implantation are mainly from new lesions emerging from other sites than the DES-treated lesions. This means that ordinary medications for CAD such as statins are still mandatory drugs even in the era of DES.
Methods and Results To evaluate the effects of statins after coronary stent implantation on subsequent cardiovascular events, a PROBE design trial conducted at 55 medical centers in Japan. 1,019 patients with acute or chronic CAD in normal total cholesterol levels were enrolled and randomly assigned to receive any available statins or not. The primary endpoint was a composite of cardiovascular death, nonfatal MI, uAP, CHF and stroke. Indications of PCI were stable angina in 55%, STEACS in 40% and NSTEACS in 5%. LDL-C (mg/dl) reduced from 133 to 96 by discretional statins of normal doses. Primary end point events occurred in 9.4% in the statin and 14.7% in non-statin groups (p=0.0228 by Logrank test). Of all primary endpoint events, uAP was significantly suppressed by statin treatment (p=0.0028 by Logrank test). Both restenosis and new lesions were equally reduced by statins (Table 1⇓).
Conclusions For normocholesterolemic Japanese patients treated with coronary stents, lipid-lowering therapy with statins reduces recurrent cardiovascular events, in particular uAP during the 2-years follow-up period. Combination of both DES and statins treatment going for <100mg/dl of LDL-C effectively reduced restenosis and new lesion emerging after PCI.