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Association between pre-treatment with statin and its inhibitory effect on the onset of coronary artery disease at the time of coronary computed tomography angiography: a new look at an old medication

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Abstract

Coronary artery stenosis is often advanced by the time coronary computed tomography angiography (CCTA). Statins are the most important anti-lipidemic medication for improving the prognosis of coronary artery disease (CAD) patients. Although lipid-lowering therapy using statins appears to have been established as a method for preventing CAD, there remains the problem that CAD cannot be completely suppressed. In this study, we investigated whether pre-treatment with statin could significantly inhibit the onset of CAD when patients received CCTA for screening of CAD. The subjects were 1164 patients who underwent CCTA as screening for CAD. CAD was diagnosed when 50% or more coronary stenosis was present in the coronary arteries. Patient backgrounds were investigated by age, gender, body mass index, coronary risk factors [family history of cardiovascular diseases, smoking history, hypertension (HTN), diabetes mellitus (DM), dyslipidemia, chronic kidney disease (CKD) or metabolic sydrome] and medications. Patients were classified into two groups according to the presence or absence of statin pre-administration during CCTA [statin (−) group (n = 804) and (+) group (n = 360)]. Compared with the statin (−) group, the statin (+) group was significantly older and had higher rates of family history, HTN, and DM. The statin (+) group had a significantly higher % CAD than the statin (−) group. Serum levels of low-density lipoprotein cholesterol (LDL-C) were significantly lower in the statin (+) group than in the statin (−) group. There was no significant difference in either high-density lipoprotein cholesterol levels or triglyceride levels between the two groups. Age, male gender, HTN, DM and pre-treatment with statin were all associated with CAD (+) in all patients. In addition, factors that contributed to CAD (+) in the statin (−) group were age, male gender, and DM, and factors that contributed to CAD (+) in the statin (+) group were age, smoking, HTN and % maximum dose of statin. At the time of CCTA, the statin (+) group had a high rate of CAD and coronary artery stenosis progressed despite a reduction of LDL-C levels. To prevent the onset of CAD, in addition to strict control of other coronary risk factors (HTN etc.), further LDL cholesterol-lowering therapy may be necessary.

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References

  1. Chapman MJ, Redfern JS, McGovern ME, Giral P (2010) Niacin and fibrates in atherogenic dyslipidemia: pharmacotherapy to reduce cardiovascular risk. Pharmacol Ther 126:314–345

    Article  CAS  PubMed  Google Scholar 

  2. Sever PS, Dahlöf B, Poulter NR, Wedel H, Beevers G, Caulfield M, Collins R, Kjeldsen SE, Kristinsson A, McInnes GT, Mehlsen J, Nieminen M, O'Brien E, Ostergren J, ASCOT investigators (2003) Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial–Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet 361:1149–1158

  3. Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto AM Jr, Kastelein JJ, Koenig W, Libby P, Lorenzatti AJ, MacFadyen JG, Nordestgaard BG, Shepherd J, Willerson JT, Glynn RJ, JUPITER Study Group (2008) Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med 359:2195–2207

    Article  Google Scholar 

  4. Abe M, Ozaki Y, Takahashi H, Ishii M, Masunaga N, Ismail TF, Iimuro S, Fujita R, Iwata H, Sakuma I, Nakagawa Y, Hibi K, Hiro T, Fukumoto Y, Hokimoto S, Miyauchi K, Ogawa H, Daida H, Shimokawa H, Saito Y, Matsuzaki M, Akao M, Kimura T, Nagai R (2021) Relation of renal function to mid-term prognosis of stable angina patients with high- or low-dose pitavastatin treatment: REAL-CAD substudy. Am Heart J 240:89–100

    Article  CAS  PubMed  Google Scholar 

  5. Nissen SE, Nicholls SJ, Sipahi I, Libby P, Raichlen JS, Ballantyne CM, Davignon J, Erbel R, Fruchart JC, Tardif JC, Schoenhagen P, Crowe T, Cain V, Wolski K, Goormastic M, Tuzcu EM, ASTEROID Investigators (2006) Effect of very high-intensity statin therapy on regression of coronary atherosclerosis: the ASTEROID trial. JAMA 295:1556–1565

  6. Nissen SE, Tuzcu EM, Schoenhagen P, Brown BG, Ganz P, Vogel RA, Crowe T, Howard G, Cooper CJ, Brodie B, Grines CL, DeMaria AN, REVERSAL Investigators (2004) Effect of intensive compared with moderate lipid-lowering therapy on progression of coronary atherosclerosis: a randomized controlled trial. JAMA 291:1071–1080

  7. Takayama T, Hiro T, Yamagishi M, Daida H, Hirayama A, Saito S, Yamaguchi T, Matsuzaki M, COSMOS Investigators (2009) Effect of rosuvastatin on coronary atheroma in stable coronary artery disease: multicenter coronary atherosclerosis study measuring effects of rosuvastatin using intravascular ultrasound in Japanese subjects (COSMOS). Circ J 73:2110–2117

  8. Hiro T, Kimura T, Morimoto T, Miyauchi K, Nakagawa Y, Yamagishi M, Ozaki Y, Kimura K, Saito S, Yamaguchi T, Daida H, Matsuzaki M, JAPAN-ACS Investigators (2009) Effect of intensive statin therapy on regression of coronary atherosclerosis in patients with acute coronary syndrome: a multicenter randomized trial evaluated by volumetric intravascular ultrasound using pitavastatin versus atorvastatin (JAPAN-ACS [Japan assessment of pitavastatin and atorvastatin in acute coronary syndrome] study). J Am Coll Cardiol 54:293–302

  9. Nakamura H, Arakawa K, Itakura H, Kitabatake A, Goto Y, Toyota T, Nakaya N, Nishimoto S, Muranaka M, Yamamoto A, Mizuno K, Ohashi Y, MEGA Study Group (2006) Primary prevention of cardiovascular disease with pravastatin in Japan (MEGA Study): a prospective randomised controlled trial. Lancet 368:1155–1163

    Article  Google Scholar 

  10. Scandinavian Simvastatin Survival Study Group (1994) The Scandinavian Simvastatin Survival Study (4S) (1994) Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet 344:1383–1389

    Google Scholar 

  11. Mitsutake R, Niimura H, Miura S, Zhang B, Iwata A, Nishikawa H, Kawamura A, Kumagai K, Shirai K, Matsunaga A, Saku K (2006) Clinical significance of the coronary calcification score by multidetector row computed tomography for the evaluation of coronary stenosis in Japanese patients. Circ J 70:1122–1127

    Article  PubMed  Google Scholar 

  12. Tsukihashi Y, Shiga Y, Suematsu Y, Idemoto Y, Tashiro K, Yano Y, Kato Y, Kuwano T, Sugihara M, Miura S (2021) Presence and severity of coronary artery disease in patients who achieved intensive blood pressure reduction at the time of coronary computed tomography angiography. Hypertens Res 44:206–214

    Article  CAS  PubMed  Google Scholar 

  13. Inoue H, Shiga Y, Norimatsu K, Tashiro K, Futami M, Suematsu Y, Sugihara M, Nishikawa H, Katsuda Y, Miura S (2021) Associations between high-density lipoprotein functionality and major adverse cardiovascular events in patients who have undergone coronary computed tomography angiography. J Clin Med 10:2431

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  14. Kawahira Y, Shiga Y, Inoue H, Suematsu Y, Tashiro K, Kato Y, Fujimi K, Takamiya Y, Kuwano T, Sugihara M, Miura S (2021) Association between high-density lipoprotein cholesterol levels and major adverse cardiovascular events in patients who underwent coronary computed tomography angiography: FU-CCTA registry. Heart Vessels 36:1457–1465

    Article  PubMed  Google Scholar 

  15. Inoue H, Shiga Y, Tashiro K, Kawahira Y, Suematsu Y, Idemoto Y, Tano K, Kuwano T, Sugihara M, Nishikawa H, Katsuda Y, Miura S (2021) Association between the level of low-density lipoprotein cholesterol and coronary atherosclerosis in patients who have undergone coronary computed tomography angiography. Cardiol Res 12:10–15

    Article  PubMed  Google Scholar 

  16. Tashiro K, Inoue H, Shiga Y, Tsukihashi Y, Imaizumi T, Norimatsu K, Idemoto Y, Kuwano T, Sugihara M, Nishikawa H, Katsuda Y, Miura S (2020) Associations between high levels of high-density lipoprotein cholesterol and the presence and severity of corona artery disease in patients who have undergone coronary computed tomography angiography. J Clin Med Res 12:734–739

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  17. Norimatsu K, Kuwano T, Miura S, Shimizu T, Shiga Y, Suematsu Y, Miyase Y, Adachi S, Nakamura A, Imaizumi S, Iwata A, Nishikawa H, Uehara Y, Saku K (2017) Significance of the percentage of cholesterol efflux capacity and total cholesterol efflux capacity in patients with orwithout coronary artery disease. Heart Vessels 32:30–38

    Article  PubMed  Google Scholar 

  18. Shiga Y, Miura S, Mitsutake R, Kawamura A, Uehara Y, Saku K (2010) Significance of serum high-density lipoprotein cholesterol levels for diagnosis of coronary stenosis as determined byMDCT in patients with suspected coronary artery disease. J Atheroscler Thromb 17:870–878

    Article  CAS  PubMed  Google Scholar 

  19. Mitsutake R, Miura S, Zhang B, Saku K (2010) HDL-associated factors provide additional prognostic information for coronary artery disease as determined by muldetector row computed tomography. Int J Cardiol 143:72–78

    Article  PubMed  Google Scholar 

  20. Agatston AS, Janowitz WR, Hildner FJ, Zusmer NR, Viamonte M Jr, Detrano R (1990) Quantification of coronary artery calcium using ultrafast computed tomography. J Am Coll Cardiol 15:827–832

    Article  CAS  PubMed  Google Scholar 

  21. Gensini GG (1983) A more meaningful scoring system for determining the severity of coronary heart disease. Am J Cardiol 51:606

    Article  CAS  PubMed  Google Scholar 

  22. Nordestgaard BG, Chapman MJ, Humphries SE, Ginsberg HN, Masana L, Descamps OS, Wiklund O, Hegele RA, Raal FJ, Defesche JC, Wiegman A, Santos RD, Watts GF, Parhofer KG, Hovingh GK, Kovanen PT, Boileau C, Averna M, Borén J, Bruckert E, Catapano AL, Kuivenhoven JA, Pajukanta P, Ray K, Stalenhoef AF, Stroes E, Taskinen MR, Tybjærg-Hansen A, European Atherosclerosis Society Consensus Panel (2013) Familial hypercholesterolaemia is underdiagnosed and undertreated in the general population: guidance for clinicians to prevent coronary heart disease: consensus statement of the European Atherosclerosis Society. Eur Heart J 34:3478–3490. Erratum in: Eur Heart J 2020;41:4517

  23. NDB open data (2021) https://www.mhlw.go.jp/stf/seisakunitsuite/bunya/0000177182.html accessed date 8th Nov. 2023

  24. Jones PH, Davidson MH, Stein EA, Bays HE, McKenney JM, Miller E, Cain VA, Blasetto JW, STELLAR Study Group (2003) Comparison of the efficacy and safety of rosuvastatin versus atorvastatin, simvastatin, and pravastatin across doses (STELLAR* Trial). Am J Cardiol 92:152–160

    Article  Google Scholar 

  25. Staffa JA, Chang J, Green L (2002) Cerivastatin and reports of fatal rhabdomyolysis. N Engl J Med 346:539–540

    Article  PubMed  Google Scholar 

  26. Tremblay AJ, Lamarche B, Lemelin V, Hoos L, Benjannet S, Seidah NG, Davis HR Jr, Couture P (2011) Atorvastatin increases intestinal expression of NPC1L1 in hyperlipidemic men. J Lipid Res 52:558–565

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  27. Sabatine MS, Giugliano RP, Keech AC, Honarpour N, Wiviott SD, Murphy SA, Kuder JF, Wang H, Liu T, Wasserman SM, Sever PS, Pedersen TR, FOURIER Steering Committee and Investigators (2017) Evolocumab and clinical outcomes in patients with cardiovascular disease. N Engl J Med 376:1713–1722

  28. Karalis DG (2023) Strategies of improving adherence to lipid-lowering therapy in patients with atherosclerotic cardiovascular disease. Curr Opin Lipidol 34:252–258

    Article  CAS  PubMed  Google Scholar 

  29. Okamura T, Tsukamoto K, Arai H, Fujioka Y, Ishigaki Y, Koba S, Ohmura H, Shoji T, Yokote K, Yoshida H, Yoshida M, Deguchi J, Dobashi K, Fujiyoshi A, Hamaguchi H, Hara M, Harada-Shiba M, Hirata T, Iida M, Ikeda Y, Ishibashi S, Kanda H, Kihara S, Kitagawa K, Kodama S, Koseki M, Maezawa Y, Masuda D, Miida T, Miyamoto Y, Nishimura R, Node K, Noguchi M, Ohishi M, Saito I, Sawada S, Sone H, Takemoto M, Wakatsuki A, Yanai H (2003) Japan atherosclerosis society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2022. J Atheroscler Thromb. https://doi.org/10.5551/jat.GL2022

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Pharmacy, Fukuoka University Hospital, Fukuoka, Japan

    Erika Miura-Takahashi, Yuki Otsu & Hidetoshi Kamimura

  2. Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan

    Kohei Tashiro, Yuhei Shiga, Yuto Kawahira, Yuta Kato, Takashi Kuwano, Makoto Sugihara & Shin-ichiro Miura

  3. Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan

    Erika Miura-Takahashi, Kohei Tashiro, Yuhei Shiga, Yuto Kawahira, Yuta Kato, Takashi Kuwano, Makoto Sugihara, Yuki Otsu & Shin-ichiro Miura

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  1. Erika Miura-Takahashi
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  2. Kohei Tashiro
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Miura-Takahashi, E., Tashiro, K., Shiga, Y. et al. Association between pre-treatment with statin and its inhibitory effect on the onset of coronary artery disease at the time of coronary computed tomography angiography: a new look at an old medication. Heart Vessels (2024). https://doi.org/10.1007/s00380-024-02407-4

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