Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Population Science
Low-Density Lipoprotein Cholesterol Levels on Statins and Cardiovascular Event Risk in Stable Coronary Artery Disease　― An Observation From the REAL-CAD Study ―
Toshiaki Toyota, Takeshi Morimoto, Satoshi Iimuro, Retsu Fujita, Hiroshi Iwata, Katsumi Miyauchi, Teruo Inoue, Yoshihisa Nakagawa, Yosuke Nishihata, Hiroyuki Daida, Yukio Ozaki, Satoru Suwa, Ichiro Sakuma, Yutaka Furukawa, Hiroki Shiomi, Hirotoshi Watanabe, Kyohei Yamaji, Naritatsu Saito, Masahiro Natsuaki, Yasuo Ohashi, Masunori Matsuzaki, Ryozo Nagai, Takeshi Kimura
Author information
Keywords: Coronary artery disease, Lipids, Statin
JOURNAL OPEN ACCESS FULL-TEXT HTML
Supplementary material

2023 Volume 87 Issue 2 Pages 360-367

Browse “Advance online publication” version
Details
Full-text HTML Download PDF (3335K)
Download citation RIS

(compatible with EndNote, Reference Manager, ProCite, RefWorks)

BIB TEX

(compatible with BibDesk, LaTeX)

Text
How to download citation
Contact us
Abstract

Background: The relationship between very low on-treatment low-density lipoprotein cholesterol (LDL-C) level and cardiovascular event risk is still unclear in patients receiving the same doses of statins.

Methods and Results: From the REAL-CAD study comparing high-dose (4 mg/day) with low-dose (1 mg/day) pitavastatin therapy in patients with stable coronary artery disease, 11,105 patients with acceptable statin adherence were divided into 3 groups according to the on-treatment LDL-C level at 6 months (<70 mg/dL, 70–100 mg/dL, and ≥100 mg/dL). The primary outcome measure was a composite of cardiovascular death, non-fatal myocardial infarction, non-fatal ischemic stroke, or unstable angina requiring emergent admission. The adjusted risks of the LDL-C <70 mg/dL group relative to the LDL-C 70–100 mg/dL group (reference) was not significantly different for the primary outcome measure in both 1 mg/day and 4 mg/day strata (HR 0.84, 95% CI 0.58–1.18, P=0.32, and HR 1.25, 95% CI 0.88–1.79, P=0.22). The adjusted risk of the LDL-C ≥100 mg/dL group relative to the reference group was not significant for the primary outcome measure in the 1 mg/day stratum (HR 0.82, 95% CI 0.60–1.11, P=0.21), whereas it was highly significant in the 4 mg/day stratum (HR 3.32, 95% CI 2.08–5.17, P<0.001).

Conclusions: A very low on-treatment LDL-C level (<70 mg/dL) was not associated with lower cardiovascular event risk compared with moderately low on-treatment LDL-C level (70–100 mg/dL) in patients receiving the same doses of statins.

Content from these authors
© 2023, THE JAPANESE CIRCULATION SOCIETY

This article is licensed under a Creative Commons [Attribution-NonCommercial-NoDerivatives 4.0 International] license.
https://creativecommons.org/licenses/by-nc-nd/4.0/
Previous article Next article
Favorites & Alerts

Recently viewed articles
Predecessor

The Nippon Journal of Clinical Angio-Cardiology

Japanese Circulation Journal

JAPANESE CIRCULATION JOURNAL

Related information

Request a Permission

Related journals
Circulation Reports
Share this page
feedback
 Top