Seo Young Sohn, Yun Jin Kim, Joon-Hyung Doh, Sung Woo Cho
{"title":"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","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":"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>","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":"{\"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\":\"<p><strong>Background: </strong>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.</p><p><strong>Methods: </strong>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.</p><p><strong>Results: </strong>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).</p><p><strong>Conclusion: </strong>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.</p>\",\"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}","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}
Moderate-Intensity Atorvastatin and Ezetimibe Combination Therapy Versus High-Intensity Atorvastatin in Patients with Angina Pectoris who Underwent Percutaneous Coronary Intervention.
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.
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.
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