Circulation journal : official journal of the Japanese Circulation Society · 2025
Efficacy and Safety of High-Intensity Statins in Japanese Patients After Percutaneous Coronary Intervention - Insights From the Clinical Deep Data Accumulation System (CLIDAS®).
СтатьяМногоцентровое исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Matoba Tetsuya, Katsuki Shunsuke, Nakano Yasuhiro, Kawahara Takuro, Kimura Mitsukuni, Hino Rissei, Tabuchi Takuya, Fukata Mitsuhiro, Hieda Michinari, Yamashita Takanori, Nakashima Naoki, Kohro Takahide, Kabutoya Tomoyuki, Oba Yusuke, Kario Kazuomi, Imai Yasushi, Fujita Hideo, Akashi Naoyuki, Kiyosue Arihiro, Mizuno Yoshiko, Kodera Satoshi, Nakayama Masaharu, Nochioka Kotaro, Miyamoto Yoshihiro, Iwai Takamasa, Tsujita Kenichi, Nakamura Taishi, Ishii Masanobu, Sato Hisahiko, Matoba Yuri, Nagai Ryozo, CLIDAS Research Group
Аннотация
BACKGROUND: Lipid-lowering therapy with high-intensity statins has not been widely implemented in Japan for patients with coronary artery disease who undergo percutaneous coronary intervention (PCI). We examined the efficacy and safety of high-intensity statin therapy in a real-world setting.
METHODS AND RESULTS: We used the Clinical Deep Data Accumulation System (CLIDAS) to accumulate multimodal data from the electronic medical records of 7 cardiovascular centers. We analyzed 9,690 patients who underwent PCI between 2013 and 2019 and completed a median 2.5-year follow-up (CLIDAS-PCI database). The risk of developing major adverse cardiac and cerebrovascular events (MACCE) was significantly greater in patients with acute (ACS) than chronic (CCS) coronary syndrome. High-intensity statins were prescribed to 49% of ACS patients and 33% of CCS patients within the first 30 days after the index PCI. After propensity score matching, MACCE event rates were similar between the high- and moderate-intensity statin groups. Importantly, among ACS patients, Cox proportional hazard analysis revealed that the rate of myocardial infarction was lower (adjusted hazard ratio [aHR] 0.65; 95% confidence interval [CI] 0.44-0.97) and the rate of stroke was greater (aHR 1.71; 95% CI 1.12-2.62) in the high-intensity statin group, driven mostly by intracranial hemorrhage.
CONCLUSIONS: The CLIDAS-PCI database provides real-world evidence for the efficacy and safety of high-intensity statins in Japanese ACS patients who have undergone PCI.
METHODS AND RESULTS: We used the Clinical Deep Data Accumulation System (CLIDAS) to accumulate multimodal data from the electronic medical records of 7 cardiovascular centers. We analyzed 9,690 patients who underwent PCI between 2013 and 2019 and completed a median 2.5-year follow-up (CLIDAS-PCI database). The risk of developing major adverse cardiac and cerebrovascular events (MACCE) was significantly greater in patients with acute (ACS) than chronic (CCS) coronary syndrome. High-intensity statins were prescribed to 49% of ACS patients and 33% of CCS patients within the first 30 days after the index PCI. After propensity score matching, MACCE event rates were similar between the high- and moderate-intensity statin groups. Importantly, among ACS patients, Cox proportional hazard analysis revealed that the rate of myocardial infarction was lower (adjusted hazard ratio [aHR] 0.65; 95% confidence interval [CI] 0.44-0.97) and the rate of stroke was greater (aHR 1.71; 95% CI 1.12-2.62) in the high-intensity statin group, driven mostly by intracranial hemorrhage.
CONCLUSIONS: The CLIDAS-PCI database provides real-world evidence for the efficacy and safety of high-intensity statins in Japanese ACS patients who have undergone PCI.