Abstract 19955: When Should Statin Therapy in Patients with Early Coronary Artery Disease Begin?: Results from the CONFIRM (COronary CT Angiography EvaluatioN for Clinical Outcomes: An InteRnational Multicenter) Registry
Background: The efficacy of statins for improving prognosis among individuals who vary depending on coronary artery calcium score (CAC) or non-obstructive coronary artery disease (CAD) by coronary computed tomographic angiography (CCTA) remains uncertain.
Objective: To assess the usefulness of statins for lowering the all-cause mortality according to the degree of CAC, especially lower-to-intermediate scoring, and non-obstructive CAD by CCTA.
Methods: Among 27,125 patients from the international multicenter CONFIRM registry, 9,229 patients (6396 without statin, 2833 with statin) without history of prior CAD or obstructive CAD (≥50% diameter stenosis) by CCTA for whom baseline statin use was available were included for analysis. Patients were followed for a 3 years for a primary endpoint of all-cause mortality and it was evaluated according to the degree of CAC or segment-involvement score (SIS).
Results: Patients with statin therapy were older, had more cardiac risk factors except smoking and showed lesser trend of mortality (0.9% vs. 1.3%, p=0.08). Baseline statin use was associated with a decreased annual mortality for individuals with presence of CAC (0.9% without statin vs. 0.3% with statin in CAC 1-299, p<0.001; 3.0% without statin vs. 1.4% with statin in CAC≥300, p=0.07) or SIS (0.8% without statin vs. 0.5% with statin in SIS 1-2, p=0.11; 1.5% without statin vs. 0.5% with statin in SIS≥3, p=0.004), but not for those with normal coronary arteries (0.2% without statin vs. 0.3% with statin in CAC 0, p=0.77, 0.3% without statin vs. 0.2% with statin in SIS 0, p=0.76).
Conclusion: In non-obstructive CAD, higher CAC or SIS showed increased risk of mortality and statin therapy reduced the risk of mortality in existing any grade of CAC or SIS.
Author Disclosures: Y. Cho: None. C. Nam: None. J. Min: None. B. O’Hartaigh: None. H. Gransar: None.
- © 2014 by American Heart Association, Inc.