Document Detail

Comparison of preventive effect on cardiovascular events with different statins. -The CIRCLE study-.
MedLine Citation:
PMID:  21673458     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Although statins vary in their effectiveness in lowering low-density lipoprotein cholesterol (LDL-C) and increasing high-density lipoprotein cholesterol (HDL-C) levels, there is little evidence that the degree of these changes can explain cardiac risk reduction in Japan. Our objective was to compare the efficacy of statins on serum lipid levels and to explore the association between those changes and cardiac events in patients after percutaneous coronary intervention (PCI).
METHODS AND RESULTS: The 743 consecutive patients who underwent PCI from 2001 to 2008 were retrospectively investigated. Treatment with either atorvastatin or pitavastatin significantly reduced LDL-C compared with pravastatin or no statin. In contrast, only pitavastatin treatment significantly increased HDL-C (13.4 ± 22.9%, P=0.01 vs. no statin). Each statin significantly prevented major adverse cardiac events (MACE) compared with no statin, and pitavastatin was the most effective of all. Multivariate-adjusted analysis revealed that percent changes of both LDL-C and HDL-C independently predicted the incidence of MACE (hazard ratio [HR]: 1.015; 95% confidence interval [CI]: 1.010-1.020, HR: 0.988; 95%CI: 0.981-0.996, respectively). This relationship was preserved in patients with a baseline HDL-C level ≤ 45 mg/dl, but not HDL-C level > 45 mg/ml.
CONCLUSIONS: The extent of changes in LDL-C and HDL-C with statin treatment would independently alter the risk of cardiac events in Japanese patients for secondary prevention. Statins with varying lipid-modifying ability might provide differing prognosis in patients after PCI.
Takao Maruyama; Masanori Takada; Yoshiharu Nishibori; Kouichi Fujita; Koujirou Miki; Shigeki Masuda; Tetsuo Horimatsu; Toshiaki Hasuike
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article     Date:  2011-06-15
Journal Detail:
Title:  Circulation journal : official journal of the Japanese Circulation Society     Volume:  75     ISSN:  1347-4820     ISO Abbreviation:  Circ. J.     Publication Date:  2011  
Date Detail:
Created Date:  2011-07-25     Completed Date:  2011-11-18     Revised Date:  2012-01-09    
Medline Journal Info:
Nlm Unique ID:  101137683     Medline TA:  Circ J     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  1951-9     Citation Subset:  IM    
Department of Cardiology, Kawasaki Hospital, Kobe, Japan.
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MeSH Terms
Aged, 80 and over
Angioplasty / adverse effects*
Asian Continental Ancestry Group
Cardiovascular Diseases* / blood,  prevention & control
Cholesterol, HDL / blood*
Cholesterol, LDL / blood*
Heptanoic Acids / administration & dosage*
Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage*
Middle Aged
Postoperative Complications* / blood,  prevention & control
Pyrroles / administration & dosage*
Quinolines / administration & dosage*
Retrospective Studies
Risk Factors
Reg. No./Substance:
0/Cholesterol, HDL; 0/Cholesterol, LDL; 0/Heptanoic Acids; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Pyrroles; 0/Quinolines; 110862-48-1/atorvastatin; 147511-69-1/pitavastatin

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