Abstract 9597: Differential Effects of Strong and Regular Statins on Clinical Outcome in Patients With Chronic Kidney Disease Following Coronary Stent Implantation - The Kumamoto Intervention Conference Study (kics) Registry -
Introduction: Practice guidelines recommend the use of intensive statin treatment for secondary prevention in high-risk patients with clinical atherosclerotic cardiovascular disease regardless of the value of LDL-C.
Objectives: The aim of this study was to examine the effects of different statins on the clinical outcome of Japanese patients with coronary stent implants.
Methods: This prospective study included 5,801 consecutive patients (males, 4,160; age, 69.7±11.1 years, mean±SD) who underwent stent implantation between April 2008 and March 2011. They were treated with either strong statins (n=3,042, 52%, atorvastatin, pitavastatin, or rosuvastatin), regular statin (n=1,082, 19%, pravastatin, simvastatin, or fluvastatin) or no statin (n=1,677, 29%). Clinical events were monitored and compared between the two groups and patients were followed up for 12 months. Primary endpoints included cardiovascular death, nonfatal MI, including stent thrombosis and ischemic stroke.
Results: Compared with regular statin, strong statins reduced the risk of cardiovascular events of primary endpoint (HR 0.65, 95%CI 0.43-0.97; P=0.036) and ischemic stroke (HR 0.34, 95%CI 0.15-0.76; P=0.009), but not cardiovascular death (P=0.190). In subgroup analysis of patients with chronic kidney disease (CKD), statin improved the clinical outcome for both primary endpoint (HR 0.45, 95%CI 0.25-0.80; P=0.008) and cardiovascular death (HR 0.29, 95%CI 0.14-0.62; P=0.001). Strong statin improved prognosis regarding cardiovascular death in mild-to-moderate CKD patients (HR 0.11, 95%CI 0.02-0.56; P=0.008), but not primary endpoint or cardiovascular death in patients with severe CKD (P=0.748, P=0.595, respectively).
Conclusions: Compared with regular statin, strong statin reduced the risk of cardiovascular events in Japanese patients with stent implants. In patients with mild-to-moderate CKD, strong statin was superior to regular statin in reducing the risk of cardiovascular death.
Author Disclosures: M. Ishii: None. S. Hokimoto: None. T. Akasaka: None. K. Kaikita: Honoraria; Modest; AstraZeneca, Bayer, Daiichi Sankyo, Dainippon Sumitomo Pharma, Otsuka, MSD, Novartis. H. Ogawa: Other Research Support; Modest; AstraZeneca, Astellas, Boehringer lngelheim, Bristol-Myers Squibb, Daiichi Sankyo, Dainippon Sumitomo Pharma, Kowa, MSD, Novartis, Pfizer, Sanofi, Takeda. Other Research Support; Significant; Bayer, Chugai, Otsuka. Honoraria; Modest; AstraZeneca, Bayer, Pfizer, Sanofi, Takeda. Honoraria; Significant; Daiichi Sankyo, MSD.
- © 2014 by American Heart Association, Inc.