Impact of statin therapy on long-term clinical outcomes of vasospastic angina without significant stenosis: A propensity-score matched analysis

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• 作者：Min Seok Oh¹ ; ² ; Jeong Hoon Yang¹ ; ² ; Da Hyun Lee¹ ; Taek Kyu Park¹ ; Young Bin Song¹ ; Joo-Yong Hahn¹ ; Jin-Ho Choi¹ ; Sang Hoon Lee¹ ; Hyeon-Cheol Gwon¹ ; Seung-Hyuk Choi ; ¹ ; ^{sh1214.choi@samsung.com" class="auth_mail" title="E-mail the corresponding author}
• 关键词：Vasospastic angina ; Variant angina ; Statin ; Vasospasm
• 刊名：International Journal of Cardiology
• 出版年：2016
• 出版时间：15 November 2016
• 年：2016
• 卷：223
• 期：Complete
• 页码：791-796
• 全文大小：395 K

文摘

Limited data are available on the efficacy of statin therapy for secondary prevention in patients with vasospastic angina (VSA). We investigated the association of statin therapy with long-term clinical outcomes in VSA patients without significant coronary artery disease.

Methods

From January 2003 to June 2014, we enrolled a total of 804 patients with VSA proven by an ergonovine provocation test without significant (≥ 70% diameter stenosis) coronary artery disease. We classified patients into a statin group (n = 330) and a no-statin group (n = 474) according to the use of statin. Primary outcome were major adverse cardiovascular events (MACE) defined as a composite of cardiovascular death, myocardial infarction, and any revascularization.

Results

Median follow-up duration was 4.5 years (interquartile range: 2.0 to 7.3 years). MACE occurred in 14 patients (4.2%) in the statin group, and 21 patients (4.4%) in the no-statin group. There were no differences between the two groups (p = 0.97). After 1:1 propensity-score matching (281 pairs), MACE (statin versus [vs.] no-statin; 3.2% vs. 4.3%, hazard ratio [HR]; 0.80, 95% confidence interval [CI]; 0.34–1.89, p = 0.60) and readmission due to chest pain (17.1% vs. 17.4%, HR; 1.08, 95% CI; 0.72–1.06, p = 0.72) were not statistically different between the two groups.

Conclusion

Our results suggest that statin therapy could not improve long-term clinical outcomes in VSA patients without significant coronary artery disease.