European Radiology

, Volume 23, Issue 11, pp 2954–2960

Statin therapy in patients with atypical chest pain and mild-to-moderate coronary stenosis on 64-slice multidetector coronary computed tomography; a retrospective propensity score matching analysis

  • Hyo Eun Park
  • Goo-Yeong Cho
  • Yeonyee E. Yoon
  • Tae-Jin Youn
  • Eun-Ju Chun
  • Sang-Il Choi
  • Dong-Ju Choi
Cardiac

DOI: 10.1007/s00330-013-2945-4

Cite this article as:
Park, H.E., Cho, G., Yoon, Y.E. et al. Eur Radiol (2013) 23: 2954. doi:10.1007/s00330-013-2945-4

Abstract

Background

The effect of computed tomography (CT)-guided statin therapy on patients with atypical chest pain and mild-to-moderate coronary artery disease has not been elucidated yet.

Methods

A total of 1,952 patients who had 1-69 % stenosis on CT were reviewed retrospectively. After propensity score matching, 643 patients who were prescribed statins after CT (statin users) and 643 patients without statin therapy (statin non-users) were compared. Major cardiovascular events included all-cause death, acute coronary syndrome and stroke.

Results

During a median of 42 months’ follow-up, all-cause death was reported in 17 patients (1.3 %), of whom 6 (0.9 %) were statin users and 11 (1.7 %) statin nonusers. Major cardiovascular events developed in 6.1 % in the statin user group and 5.6 % in the statin non-users (P = 0.812). When evaluated according to plaque subtypes, statins showed significant benefit in patients who had non-calcified or mixed plaque (HR 0.47, 95 % CI 0.22-1.01, P = 0.047). However, in patients with calcified plaques, statins had no benefit in reducing adverse events (P = 0.620).

Conclusion

In most patients with mild-to-moderate coronary artery stenosis on CT, statin therapy has no beneficial effect on reducing adverse events. However, in patients with non-calcified or mixed plaques, statin therapy showed a significant benefit.

Key Points

Multidetector CT now identifies numerous subjects with mild-to-moderate coronary stenosis.

Statin therapy has little beneficial effect on patients with calcified plaques.

However, statins reduce adverse events in those with non-calcified or mixed plaques.

Keywords

StatinCardiovascular outcomeComputed tomographyCoronary artery stenosisAngina pectoris

Copyright information

© European Society of Radiology 2013

Authors and Affiliations

  • Hyo Eun Park
    • 1
  • Goo-Yeong Cho
    • 2
    • 4
  • Yeonyee E. Yoon
    • 2
  • Tae-Jin Youn
    • 2
  • Eun-Ju Chun
    • 3
  • Sang-Il Choi
    • 3
  • Dong-Ju Choi
    • 2
  1. 1.Healthcare System Gangnam CenterSeoul National University HospitalSeoulSouth Korea
  2. 2.Division of CardiologySeoul National University Bundang HospitalSeongnamSouth Korea
  3. 3.Division of RadiologySeoul National University Bundang HospitalSeongnamSouth Korea
  4. 4.Division of Cardiology, Department of Internal MedicineSeoul National University College of Medicine, Seoul National University Bundang HospitalSeongnam-siKorea