Circulation reports · 2026
High-Intensity Statins and the Post-Discharge Clinical Outcomes at 1 Year After Percutaneous Coronary Intervention: Insights From STOPDAPT-3.
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Kimura Tomoya, Watanabe Hirotoshi, Morimoto Takeshi, Natsuaki Masahiro, Yamamoto Ko, Obayashi Yuki, Nishikawa Ryusuke, Ando Kenji, Suwa Satoru, Isawa Tsuyoshi, Takenaka Hiroyuki, Ishikawa Tetsuya, Yokomatsu Takafumi, Chinen Toshiya, Doijiri Tatsuki, Kozuma Ken, Nishida Yasunori, Yamaguchi Koji, Kitahara Hideki, Ishino Mitsunori, Ono Koh, Kimura Takeshi, STOPDAPT-3 Investigators
Аннотация
BACKGROUND: The use of high-intensity statins is recommended to improve the prognosis of coronary artery disease. However, it remains unclear whether they offer a short-term benefit after percutaneous coronary intervention (PCI), regardless of the acute coronary syndrome (ACS) status.
METHODS AND RESULTS: We performed a post hoc analysis of STOPDAPT-3, which compared 1-month aspirin-free prasugrel monotherapy followed by clopidogrel monotherapy with 1-month dual antiplatelet therapy (DAPT) followed by aspirin monotherapy in patients with ACS or a high bleeding risk undergoing PCI. High-intensity statins were defined as the maximum approved dose of strong statins in Japan (e.g., rosuvastatin 10 mg, atorvastatin 20 mg, or pitavastatin 4 mg). Two co-primary endpoints were the study-defined cardiovascular composite endpoint and bleeding endpoint, assessed between hospital discharge and 1 year after randomization. Among 5,823 patients discharged alive, 2,829 (48.6%) received high-intensity statins (ACS 54.4%; non-ACS 31.5%; P<0.001). The 1-year post-discharge cumulative incidence of cardiovascular events was similar between patients who received high-intensity statins and those who did not (3.90% vs. 4.27%, P=0.51; adjusted HR 1.03; 95% CI 0.74-1.44; P=0.84).
CONCLUSIONS: In STOPDAPT-3, high-intensity statin therapy at discharge was not associated with a reduced risk of cardiovascular events 1 year after PCI, under the limitations of having no laboratory test or prescription data available during the follow up.
METHODS AND RESULTS: We performed a post hoc analysis of STOPDAPT-3, which compared 1-month aspirin-free prasugrel monotherapy followed by clopidogrel monotherapy with 1-month dual antiplatelet therapy (DAPT) followed by aspirin monotherapy in patients with ACS or a high bleeding risk undergoing PCI. High-intensity statins were defined as the maximum approved dose of strong statins in Japan (e.g., rosuvastatin 10 mg, atorvastatin 20 mg, or pitavastatin 4 mg). Two co-primary endpoints were the study-defined cardiovascular composite endpoint and bleeding endpoint, assessed between hospital discharge and 1 year after randomization. Among 5,823 patients discharged alive, 2,829 (48.6%) received high-intensity statins (ACS 54.4%; non-ACS 31.5%; P<0.001). The 1-year post-discharge cumulative incidence of cardiovascular events was similar between patients who received high-intensity statins and those who did not (3.90% vs. 4.27%, P=0.51; adjusted HR 1.03; 95% CI 0.74-1.44; P=0.84).
CONCLUSIONS: In STOPDAPT-3, high-intensity statin therapy at discharge was not associated with a reduced risk of cardiovascular events 1 year after PCI, under the limitations of having no laboratory test or prescription data available during the follow up.