Abstract
Aspirin is the standard therapy applied after coronary intervention, and statins are also prescribed to prevent secondary coronary heart disease. We assessed the ability of a combination of statins and aspirin to improve the longterm prognosis of patients after percutaneous coronary intervention (PCI). We collected data from 575 consecutive patients who underwent PCI. The patients were divided into groups depending on the presence or absence of statin or aspirin therapy as follows: both statin and aspirin (Group B: n = 190; 33%); aspirin only (Group A: n = 236; 41.1%); statin only (Group S: n = 53; 9.2%S); neither drug (Group N: n = 96; 16.7%). Data were statistically assessed using the Cox proportional hazard model for multivariate analysis with adjustment of baseline convariates. Sixty-eight patients died during follow-up (11 ± 3 years). Multivariate analysis showed that compared with group N, both groups S and A were independent predictors for survival from all causes [group S: hazards ratio (HR) 0.29, 95% confidence interval (CI) 0.10–0.81, P = 0.019; group A: HR 0.31, 95% CI 0.17–0.56, P < 0.0001] and cardiovascular (CV) death (group S: HR 0.16, 95% CI 0.04–0.73, P = 0.018; group A: HR 0.12, 95% CI 0.05–0.30, P < 0.001). risk for all causes and CV death was significantly lower in Group B (HR 0.25, 95% CI 0.12–0.53, P < 0.0001 and HR 0.10, 95% CI 0.03–0.31, P < 0.0001, respectively). Therapy with statins plus aspirin improves long-term clinical outcome in patients after PCI.
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References
Peto R, Gray R, Collins R, Wheatley K, Hennekens C, Jamirozik K, Warlow C, Hafner B, Thompson E, Norton S (1988) Randomized trial of prophylactic daily aspirin in British male doctors. Br Med J (Clin Res Ed) 296:313–316
Final report on the aspirin component of the ongoing Physician’s Health Study. Steering Committee of Physician’s health study Research Group (1989) N Engl J Med 321:129–135
Manson JE, Stampfer MJ, Colditz GA, Willett WC, Rosner B, Speinzer FE, Hennekens CH (1991) A prospective study of aspirin use and primary prevention of cardiovascular disease in women. JAMA 266:521–527
Fuster V, Dyken ML, Vokonas PS, Hennekens C (1993) Aspirin as a therapeutic agent in cardiovascular disease. Special Writing Group. Circulation 87:659–675
Hennekens CH, Buring JE, Sandercock P, Collins R, Peto R (1989) Aspirin and other antiplatelet agents in the secondary and primary prevention of cardiovascular disease. Circulation 80:749–756
Antiplatelet Trialists’ Collaboration (1988) Secondary prevention of vascular disease by prolonged antiplatelet treatment. Br Med J (Clin Res Ed) 296:320–331
Matsuo T, Iwade K, Hirata N, Yamashita M, Ikegami H, Tanaka N, Aosaki M, Kasanuki H (2005) Improvement of arterial stiffness by the antioxidant and anti-inflammatory effects of short-term statin therapy in patients with hypercholesterolemia. Heart Vessels 20(1):8–12
Serruys PW, de Feyter P, Macaya C, Kokott N, Puel J, Vrolix M, Branzi A, Bertolami MC, Jackson G, Strauss B, Meier B (2002) Fluvastatin for prevention of cardiac events following successful first percutaneous coronary intervention. A randomized controlled trial. JAMA 287:3215–3222
Antithrombotic Trialists’ Collaboration (2002) Collaborative metaanalysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 324:71–86
Njaman WJ, Miyauchi K, Kasai T, Kurata T, Satoh H, Ohta H, Okazaki S, Yokoyama K, Kojima T, Akimoto Y, Daida H (2006) Impact of aspirin treatment on long-term outcome (over 10 years) after percutaneous coronary intervention. Int Heart J 47:37–45
Scandinavian Simvastatin Survival Study Group (1994) Randomized trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 344:1383–1389
Sacks FM, Pfeffer MA, Moye LA, Rouleau JL, Rutherford JD, Cole TG, Brown L, Warnica JW, Arnold JM, Wun CC, Davis BR, Braunwald E (1996) The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels: Cholesterol and Recurrent Event Trial investigators. N Engl J Med 335:1001–1009
The Long-Term Intervention with Pravastatin in Ischemic Disease (LIPID) Study Group (1998) Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med 339:1349–1357
Hippisley-Cox J, Coupland C (2005) Effect of combination of drugs on all cause mortality in patients with ischemic heart disease; nested case-control analysis. BMJ 330:1059–1063
Athyros VG, Mikhailidis DP, Papageorgiou AA, Bouloukos VI, Pehlivanidis AN, Symeonides AN, Kakafika AI, Daskalopulou SS, Elisaf M (2005) Effect of statins and aspirin alone and in combination on clinical outcome in dyslipidaemic patients with coronary heart disease. A subgroup analysis of the GREACE study. Platelets 16:65–71
Wascher TC (2003) Long-term statin safety and efficacy in secondary prevention can combination therapy improve outcomes? Atheroscler Suppl 14:11–16
Zhdanova IV, Tsvirenko SV, Barats SS, Smolenskaia OG, Volkova RF, Serezhenko TO (2002) Effect of fluvastatin and its combination with aspirin and trental on hemostasis and microcirculation in atherosclerosis. Ter Arkh 74:9–12
Ikonomidis I, Andreotti F (1999) Increased proinflammatory cytokines in patients with chronic stable angina and their reduction by aspirin. Circulation 100:793–798
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Kubota, N., Kasai, T., Miyauchi, K. et al. Therapy with statins and aspirin enhances long-term outcome of percutaneous coronary intervention. Heart Vessels 23, 35–39 (2008). https://doi.org/10.1007/s00380-007-1007-8
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DOI: https://doi.org/10.1007/s00380-007-1007-8