A review of statin use in patients with acute coronary syndrome in Western and Japanese populations

Abstract

Early high-dose statin therapy to reduce low-density lipoprotein cholesterol (LDL-C) is associated with improved cardiovascular outcomes in Western patients with stable coronary heart disease or acute coronary syndromes (ACS), but many patients remain undertreated and do not attain LDL-C treatment goals. Early statin therapy has also been shown to improve cardiovascular outcomes in Japanese patients with ACS, and pretreatment with high-dose statin prior to percutaneous coronary intervention has been shown to reduce cardiovascular events in these patients. As is the case in Western populations, many Japanese patients may be undertreated and a residual cardiovascular risk remains. While differences in treatment practice, dosing and genetic factors exist between Japan and Western countries, similarities are also evident when Japanese statin studies are compared with those performed in Western populations. With the increasing prevalence of cardiovascular risk factors in Japan, aggressive statin treatment may be beneficial in achieving optimal cardiovascular outcomes.

Assessment of the LDL-C/HDL-C ratio as a predictor of one year clinical outcomes in patients with acute coronary syndromes after percutaneous coronary intervention and drug-eluting stent implantation

“…According to the current European guidelines, as well as the US guidelines, a treatment goal of LDL-C < 70 mg/dL is recommended [16, 17]. In spite of the emphasis of guidelines on the tight control of the LDL-C level, several surveys have shown that still a large number of patients remain undertreated and do not attain LDL-C treatment goals [11, 12, 27]. Similarly, our result is in line with that reported in previous studies.…”

Cognitive function in patients with coronary artery disease: A literature review

“…Statins limit cholesterol synthesis and increase LDL-C catabolism. 64 They have demonstrated clear benefits in reducing morbidity and mortality in the secondary prevention of CAD but have been thought to be associated with decreased cognition because of low concentrations of LDL-C. However, a recent study by Rej et al.…”

Initial pathological responses of second-generation everolimus-eluting stents implantation in Japanese coronary arteries: Comparison with first-generation sirolimus-eluting stents

“…Furthermore, progress of patients after DES implantation is carefully observed with well-controlled drug compliance including anti-platelet agents [20]. In addition to these factors derived from the medical side, Japanese are different from Caucasian in the viewpoints of patients' lipid profiles due to genetic and environmental factors [34].…”