Impact of statins in patients with vasospastic angina: A multicenter registry study of the Japanese Coronary Spasm Association
Impact of statins in patients with vasospastic angina: A multicenter registry study of the Japanese Coronary Spasm Association
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DOI：
10.1016/j.jjcc.2022.03.009
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发表时间：
2022-07-27
影响因子：
2.5
通讯作者：
Suzuki, Hiroshi
中科院分区：
文献类型：
--
作者：
Mori, Hiroyoshi;Takahashi, Jun;Suzuki, Hiroshi
背景：他汀类药物一般用于冠心病患者。然而，他汀类药物对血管痉挛性心绞痛（VSA）患者的影响尚不完全清楚。方法：在日本冠状动脉痉挛协会的一项多中心注册研究中（n =1429），比较使用或不使用他汀类药物的患者。主要终点是主要心脏不良事件（mace），定义为心源性死亡、非致死性心肌梗死、不稳定型心绞痛、心力衰竭和适当的植入式心律转复除颤器休克。使用倾向评分匹配和多变量Cox比例风险模型来调整治疗和潜在混杂因素的选择偏倚。结果：在整个人群中，469例患者接受了他汀类药物治疗，960例患者未接受他汀类药物治疗。与未服用他汀类药物的患者相比，服用他汀类药物的患者有更高的合并症患病率，包括高血压、糖尿病、血脂异常和吸烟。既往心肌梗死、明显器质性狭窄和药物使用（包括钙通道阻滞剂、血管紧张素转换酶抑制剂/血管紧张素受体阻滞剂和β受体阻滞剂）的患病率在服用他汀类药物的患者中高于未服用他汀类药物的患者。倾向匹配后（两组n = 211）， Kaplan-Meier曲线分析显示，使用和不使用他汀类药物的患者MACE发生率具有可比性（p = 0.686）。使用他汀类药物的患者中有6.0%发生mace，未使用他汀类药物的患者中有5.9%发生mace （p = 0.98）。结论：在这项多中心注册研究中，他汀类药物治疗并没有减少VSA患者的临床事件。(c) 2022年日本心脏病学院。Elsevier Ltd.出版。版权所有。
Background: Statins are generally used for patients with coronary artery disease. However, the impact of statins in patients with vasospastic angina (VSA) is not fully understood.Methods: In a multicenter registry study of the Japanese Coronary Spasm Association (n =1429), patients with or without statins were compared. The primary endpoint was major adverse cardiac events (MACEs), defined as cardiac death, non-fatal myocardial infarction, unstable angina, heart failure, and appropriate implantable cardioverter defibrillator shock. Propensity score matching and a multivariable Cox proportional hazard model were used to adjust for selection bias in treatment and potential confounding factors. Results: In the whole population, 469 patients received statins, while 960 patients did not receive statins. Patients with statins had a greater prevalence of comorbidities, including hypertension, diabetes, dyslipidemia, and smoking, in comparison to those without statins. The prevalence rates of previous myocardial infarction, significant organic stenosis, and medication use (including calcium channel blockers, angiotensin-converting enzyme inhibitor/angiotensin receptor blockers, and beta blockers) were greater in patients with statins than in those without statins. After propensity matching (n = 211 for both groups), a Kaplan-Meier curve analysis revealed that the incidence of MACE was comparable between patients with and without statins (p = 0.686). MACEs occurred in 6.0% of patients with statins and in 5.9% of those without statins (p = 0.98).Conclusion: In this multicenter registry study, statin therapy did not reduce clinical events in VSA patients. (c) 2022 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.