What Is the Appropriate Duration of High-Dose Atorvastatin Therapy Post-Acute Coronary Syndrome?

Goriacko, Pavel; Andersen, Matthew; Fazylov, Roman; Plakogiannis, Roda

doi:10.1177/0897190014544796

Cited by 1 publication

(1 citation statement)

References 17 publications

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“…Therefore, adherence to statin therapy may be critical for explaining the cardiovascular benefits of statins in clinical practice. We noted that only a few studies regarding statin therapy duration have been conducted [10,11]. In addition, the duration of followup in many previous RCT on statins was often not long enough to observe the life-long effects of statin therapy [12][13][14].…”

Section: Introductionmentioning

confidence: 99%

Relative contributions of statin intensity, achieved low-density lipoprotein cholesterol level, and statin therapy duration to cardiovascular risk reduction in patients with type 2 diabetes: population based cohort study

Kim

Choi

Kim

et al. 2022

Cardiovasc Diabetol

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Background Current guidelines recommend life-long use of statin for patients with type 2 diabetes (T2D), however, a number of patients discontinue statin therapy in clinical practice. We aimed to estimate the optimal statin therapy including statin therapy duration, statin intensity, and low-density lipoprotein cholesterol (LDL-C) level among patients with T2D in a real-world setting. Methods From Korean National Health Insurance Service Cohort (2007–2015), 8937 patients with T2D (≥ 40 years of age) who received statin therapy for at least 90 days were included. Risk of major adverse cardiovascular event (MACE) including ischemic heart disease, ischemic stroke, and cardiovascular death was estimated according to statin intensity, achieved serum LDL-C level, and statin therapy duration, respectively. The relative contributions of these factors to MACE risk were quantified by calculating the proportion of log-likelihood explained by each factor. Results The hazard ratio (HR) of MACE was lower in patients receiving moderate- or high-intensity statins than in those receiving low-intensity statins (HR, 0.72; p = 0.027). Among patients who received moderate- or high-intensity statins, lower achieved LDL-C level was associated with lower cardiovascular risk. Notably, the longer the patients received statins, the lower was the risk of MACE; the HR of MACE was significantly reduced after at least 18 months (adjusted HR, 0.70; p = 0.009) as a reference to 3–6 months of therapy. The proportion of explainable log-likelihood for MACE was greatest for statin duration (2.55), followed by achieved LDL-C level (2.18), and statin intensity (0.95). Conclusions Statin therapy duration is as important as or more crucial than statin intensity or achieved LDL-C level for the reduction of cardiovascular risk in T2D patients. The concept of “longer is better” regarding statin therapy should be considered in clinical practice.

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Section: Introductionmentioning

confidence: 99%

Relative contributions of statin intensity, achieved low-density lipoprotein cholesterol level, and statin therapy duration to cardiovascular risk reduction in patients with type 2 diabetes: population based cohort study

Kim

Choi

Kim

et al. 2022

Cardiovasc Diabetol

View full text Add to dashboard Cite

show abstract

What Is the Appropriate Duration of High-Dose Atorvastatin Therapy Post-Acute Coronary Syndrome?

Abstract: After an ACS, high-dose atorvastatin should be continued for at least 5 years. High-dose atorvastatin demonstrated a reduction in coronary events but dose reductions and higher discontinuation rates were also noted.

Cited by 1 publication

References 17 publications

Relative contributions of statin intensity, achieved low-density lipoprotein cholesterol level, and statin therapy duration to cardiovascular risk reduction in patients with type 2 diabetes: population based cohort study

Relative contributions of statin intensity, achieved low-density lipoprotein cholesterol level, and statin therapy duration to cardiovascular risk reduction in patients with type 2 diabetes: population based cohort study

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