Moderate-Intensity Atorvastatin and Ezetimibe Combination Therapy Versus High-Intensity Atorvastatin in Patients with Angina Pectoris who Underwent Percutaneous Coronary Intervention.

IF 3.1 3区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Drugs and Therapy Pub Date : 2025-08-01 DOI:10.1007/s10557-025-07729-7

Seo Young Sohn, Yun Jin Kim, Joon-Hyung Doh, Sung Woo Cho

{"title":"Moderate-Intensity Atorvastatin and Ezetimibe Combination Therapy Versus High-Intensity Atorvastatin in Patients with Angina Pectoris who Underwent Percutaneous Coronary Intervention.","authors":"Seo Young Sohn, Yun Jin Kim, Joon-Hyung Doh, Sung Woo Cho","doi":"10.1007/s10557-025-07729-7","DOIUrl":null,"url":null,"abstract":"Background: Whether moderate-intensity statin and ezetimibe combination therapy is beneficial compared to high-intensity statin monotherapy in patients with angina pectoris who underwent percutaneous coronary intervention (PCI) remains unclear. We aimed to investigate the effect of moderate-intensity atorvastatin with ezetimibe combination therapy after PCI in patients with angina pectoris, but not myocardial infarction (MI), in real-world practice.Methods: This retrospective cohort study used data from the Korean National Health Insurance Database. Altogether 6784 patients who underwent PCI between 2015 and 2018 received either moderate-intensity atorvastatin (10 and 20 mg) and ezetimibe 10 mg (n = 4682) or high-intensity atorvastatin (40 and 80 mg; n = 2102). The primary outcome was a composite of cardiovascular death, MI, coronary revascularization, and stroke. Subgroup analyses were performed on the basis of baseline comorbidities.Results: During the follow-up (mean duration of 4 years), incidence rates of the primary outcome were 70.14 and 62.05 per 1000 person-years in the moderate-intensity atorvastatin plus ezetimibe and high-intensity atorvastatin groups, respectively, with no significant differences in the risk of primary outcome between the two groups [hazard ratio (HR), 0.99; 95% confidence interval (CI) 0.90-1.10]. However, in patients with underlying chronic kidney disease (CKD), moderate-intensity atorvastatin with ezetimibe combination therapy was associated with a lower risk of primary outcome compared to high-intensity atorvastatin therapy (HR 0.40, 95% CI 0.18-0.86).Conclusion: In this real-world cohort study, there was no significant difference in cardiovascular outcomes between moderate-intensity atorvastatin plus ezetimibe combination therapy and high-intensity atorvastatin monotherapy in patients with angina pectoris who underwent PCI. Moderate-intensity atorvastatin and ezetimibe combination therapy may be beneficial, particularly in patients with CKD.","PeriodicalId":9557,"journal":{"name":"Cardiovascular Drugs and Therapy","volume":" ","pages":""},"PeriodicalIF":3.1000,"publicationDate":"2025-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Cardiovascular Drugs and Therapy","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10557-025-07729-7","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

Abstract

Background: Whether moderate-intensity statin and ezetimibe combination therapy is beneficial compared to high-intensity statin monotherapy in patients with angina pectoris who underwent percutaneous coronary intervention (PCI) remains unclear. We aimed to investigate the effect of moderate-intensity atorvastatin with ezetimibe combination therapy after PCI in patients with angina pectoris, but not myocardial infarction (MI), in real-world practice.

Methods: This retrospective cohort study used data from the Korean National Health Insurance Database. Altogether 6784 patients who underwent PCI between 2015 and 2018 received either moderate-intensity atorvastatin (10 and 20 mg) and ezetimibe 10 mg (n = 4682) or high-intensity atorvastatin (40 and 80 mg; n = 2102). The primary outcome was a composite of cardiovascular death, MI, coronary revascularization, and stroke. Subgroup analyses were performed on the basis of baseline comorbidities.

Results: During the follow-up (mean duration of 4 years), incidence rates of the primary outcome were 70.14 and 62.05 per 1000 person-years in the moderate-intensity atorvastatin plus ezetimibe and high-intensity atorvastatin groups, respectively, with no significant differences in the risk of primary outcome between the two groups [hazard ratio (HR), 0.99; 95% confidence interval (CI) 0.90-1.10]. However, in patients with underlying chronic kidney disease (CKD), moderate-intensity atorvastatin with ezetimibe combination therapy was associated with a lower risk of primary outcome compared to high-intensity atorvastatin therapy (HR 0.40, 95% CI 0.18-0.86).

Conclusion: In this real-world cohort study, there was no significant difference in cardiovascular outcomes between moderate-intensity atorvastatin plus ezetimibe combination therapy and high-intensity atorvastatin monotherapy in patients with angina pectoris who underwent PCI. Moderate-intensity atorvastatin and ezetimibe combination therapy may be beneficial, particularly in patients with CKD.

查看原文本刊更多论文

中等强度阿托伐他汀和依折替贝联合治疗与高强度阿托伐他汀对经皮冠状动脉介入治疗心绞痛患者的影响

背景：对于接受经皮冠状动脉介入治疗（PCI）的心绞痛患者，中等强度的他汀类药物和依折替米贝联合治疗是否比高强度的他汀类药物单药治疗有益尚不清楚。我们的目的是研究中等强度阿托伐他汀与依折替米贝联合治疗心绞痛患者PCI后的效果，但在现实世界的实践中，不是心肌梗死（MI）。方法：本回顾性队列研究使用韩国国民健康保险数据库的数据。2015年至2018年期间接受PCI治疗的6784例患者接受了中强度阿托伐他汀（10和20 mg）和依折替贝（10 mg）（n = 4682）或高强度阿托伐他汀(40和80 mg；n = 2102)。主要结局是心血管死亡、心肌梗死、冠状动脉血运重建术和中风的综合结果。根据基线合并症进行亚组分析。结果：在随访期间（平均4年），中强度阿托伐他汀加依折替贝组和高强度阿托伐他汀组的主要结局发生率分别为70.14 / 1000人/年和62.05 / 1000人/年，两组间主要结局的风险无显著差异[风险比（HR）， 0.99；95%置信区间（CI） 0.90-1.10]。然而，在患有慢性肾病（CKD）的患者中，与高强度阿托伐他汀治疗相比，中等强度阿托伐他汀与依泽替米联合治疗的主要结局风险较低（HR 0.40, 95% CI 0.18-0.86）。结论：在现实世界的队列研究中，在接受PCI治疗的心绞痛患者中，中强度阿托伐他汀加依折替贝联合治疗与高强度阿托伐他汀单药治疗的心血管结局无显著差异。中等强度的阿托伐他汀和依折替米贝联合治疗可能是有益的，特别是对于CKD患者。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Cardiovascular Drugs and Therapy 医学-心血管系统

CiteScore

8.30

自引率

0.00%

发文量

110

审稿时长

4.5 months

期刊介绍： Designed to objectively cover the process of bench to bedside development of cardiovascular drug, device and cell therapy, and to bring you the information you need most in a timely and useful format, Cardiovascular Drugs and Therapy takes a fresh and energetic look at advances in this dynamic field. Homing in on the most exciting work being done on new therapeutic agents, Cardiovascular Drugs and Therapy focusses on developments in atherosclerosis, hyperlipidemia, diabetes, ischemic syndromes and arrhythmias. The Journal is an authoritative source of current and relevant information that is indispensable for basic and clinical investigators aiming for novel, breakthrough research as well as for cardiologists seeking to best serve their patients. Providing you with a single, concise reference tool acknowledged to be among the finest in the world, Cardiovascular Drugs and Therapy is listed in Web of Science and PubMed/Medline among other abstracting and indexing services. The regular articles and frequent special topical issues equip you with an up-to-date source defined by the need for accurate information on an ever-evolving field. Cardiovascular Drugs and Therapy is a careful and accurate guide through the maze of new products and therapies which furnishes you with the details on cardiovascular pharmacology that you will refer to time and time again.