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Cross-sectional study of patients with onset of acute coronary syndrome during statin therapy.

Akuzawa N, Hatori T, Imai K, Kitahara Y, Kurabayashi M - J Clin Med Res (2015)

Bottom Line: Although statin therapy significantly reduces cardiovascular morbidity and mortality, atherosclerotic plaque progresses in some patients taking statins.TG level was the only parameter associated with LDL-C and HbA1c levels.A linear correlation between the LDL-C and TG levels, obesity, older age, male sex, and smoking may be associated with increased risk of onset of ACS early after the initiation of statin therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Gunma Chuo Hospital, 1-7-13 Koun-cho, Maebashi, Gunma 371-0025, Japan.

ABSTRACT

Background: Although statin therapy significantly reduces cardiovascular morbidity and mortality, atherosclerotic plaque progresses in some patients taking statins. This study investigated the factors associated with onset of acute coronary syndrome (ACS) early after the initiation of statin therapy.

Methods: Consecutive patients taking statins who presented with ACS (n = 64) were divided into < 1-year and > 1-year groups based on the duration of statin therapy. Patient characteristics, coronary risk factors, lesion locations, and percutaneous intervention procedures were compared between groups.

Results: The < 1-year group was significantly younger (57.6 ± 11.9 years vs. 76.6 ± 9.1 years, P < 0.01), had significantly higher body mass index (27.22 ± 4.20 kg/m(2) vs. 24.60 ± 4.65 kg/m(2), P < 0.05), higher proportion of males (94% vs. 70%, P < 0.05), higher proportion of current smokers (61% vs. 17%, P < 0.01), and lower proportions taking aspirin and calcium antagonists (both 17% vs. 57%, P < 0.05) than the > 1-year group. In the < 1-year group, there were significant correlations between the low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) levels (r = 0.649, P = 0.004) and between the TG and hemoglobin (Hb)A1c levels (r = 0.552, P = 0.018), but these correlations were not observed a year before admission. TG level was the only parameter associated with LDL-C and HbA1c levels.

Conclusions: A linear correlation between the LDL-C and TG levels, obesity, older age, male sex, and smoking may be associated with increased risk of onset of ACS early after the initiation of statin therapy. Prospective cohort studies are needed to further explore these interactions.

No MeSH data available.


Related in: MedlinePlus

Correlations between the low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) levels, and between the hemoglobin (Hb)A1c and TG levels, at admission. In the < 1-year group, the TG level was significantly correlated with the LDL-C level (r = 0.649, P = 0.004) (a) and the HbA1c level (r = 0.552, P = 0.018) (b). In the > 1-year group, there was no significant correlation between the TG and LDL-C levels (c), or between the TG and HbA1c levels (d).
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Figure 1: Correlations between the low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) levels, and between the hemoglobin (Hb)A1c and TG levels, at admission. In the < 1-year group, the TG level was significantly correlated with the LDL-C level (r = 0.649, P = 0.004) (a) and the HbA1c level (r = 0.552, P = 0.018) (b). In the > 1-year group, there was no significant correlation between the TG and LDL-C levels (c), or between the TG and HbA1c levels (d).

Mentions: Although the initial comparisons did not show significant differences in laboratory data between the < 1-year and > 1-year groups, the specific correlations that could be affected by statin therapy were investigated further. Interestingly, in the < 1-year group, there were significant correlations between the LDL-C and TG levels (r = 0.649, P = 0.004), and between the HbA1c and TG levels (r = 0.552, P = 0.018) (Fig. 1a, b), but there were no significant correlations among other background characteristics including age, BMI, and HDL-C, UA, and CRP levels. Multivariate stepwise linear regression analyses also showed significant associations between the LDL-C and TG levels, and between the HbA1c and TG levels (Table 3). There was no evidence of multicollinearity (the VIF for independent variables was < 2.0). The multiple regression coefficient (R) and coefficient of determination (R2) were 0.649 and 0.421 for the association between the LDL-C and TG levels, and 0.552 and 0.304 for the association between the HbA1c and TG levels, respectively. In the > 1-year group, there were no significant correlations between different lipid parameters including the HDL-C, LDL-C and TG levels, or between lipid parameters and other variables associated with CVD (Fig. 1c, d).


Cross-sectional study of patients with onset of acute coronary syndrome during statin therapy.

Akuzawa N, Hatori T, Imai K, Kitahara Y, Kurabayashi M - J Clin Med Res (2015)

Correlations between the low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) levels, and between the hemoglobin (Hb)A1c and TG levels, at admission. In the < 1-year group, the TG level was significantly correlated with the LDL-C level (r = 0.649, P = 0.004) (a) and the HbA1c level (r = 0.552, P = 0.018) (b). In the > 1-year group, there was no significant correlation between the TG and LDL-C levels (c), or between the TG and HbA1c levels (d).
© Copyright Policy - open access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4356093&req=5

Figure 1: Correlations between the low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) levels, and between the hemoglobin (Hb)A1c and TG levels, at admission. In the < 1-year group, the TG level was significantly correlated with the LDL-C level (r = 0.649, P = 0.004) (a) and the HbA1c level (r = 0.552, P = 0.018) (b). In the > 1-year group, there was no significant correlation between the TG and LDL-C levels (c), or between the TG and HbA1c levels (d).
Mentions: Although the initial comparisons did not show significant differences in laboratory data between the < 1-year and > 1-year groups, the specific correlations that could be affected by statin therapy were investigated further. Interestingly, in the < 1-year group, there were significant correlations between the LDL-C and TG levels (r = 0.649, P = 0.004), and between the HbA1c and TG levels (r = 0.552, P = 0.018) (Fig. 1a, b), but there were no significant correlations among other background characteristics including age, BMI, and HDL-C, UA, and CRP levels. Multivariate stepwise linear regression analyses also showed significant associations between the LDL-C and TG levels, and between the HbA1c and TG levels (Table 3). There was no evidence of multicollinearity (the VIF for independent variables was < 2.0). The multiple regression coefficient (R) and coefficient of determination (R2) were 0.649 and 0.421 for the association between the LDL-C and TG levels, and 0.552 and 0.304 for the association between the HbA1c and TG levels, respectively. In the > 1-year group, there were no significant correlations between different lipid parameters including the HDL-C, LDL-C and TG levels, or between lipid parameters and other variables associated with CVD (Fig. 1c, d).

Bottom Line: Although statin therapy significantly reduces cardiovascular morbidity and mortality, atherosclerotic plaque progresses in some patients taking statins.TG level was the only parameter associated with LDL-C and HbA1c levels.A linear correlation between the LDL-C and TG levels, obesity, older age, male sex, and smoking may be associated with increased risk of onset of ACS early after the initiation of statin therapy.

View Article: PubMed Central - PubMed

Affiliation: Department of Internal Medicine, Gunma Chuo Hospital, 1-7-13 Koun-cho, Maebashi, Gunma 371-0025, Japan.

ABSTRACT

Background: Although statin therapy significantly reduces cardiovascular morbidity and mortality, atherosclerotic plaque progresses in some patients taking statins. This study investigated the factors associated with onset of acute coronary syndrome (ACS) early after the initiation of statin therapy.

Methods: Consecutive patients taking statins who presented with ACS (n = 64) were divided into < 1-year and > 1-year groups based on the duration of statin therapy. Patient characteristics, coronary risk factors, lesion locations, and percutaneous intervention procedures were compared between groups.

Results: The < 1-year group was significantly younger (57.6 ± 11.9 years vs. 76.6 ± 9.1 years, P < 0.01), had significantly higher body mass index (27.22 ± 4.20 kg/m(2) vs. 24.60 ± 4.65 kg/m(2), P < 0.05), higher proportion of males (94% vs. 70%, P < 0.05), higher proportion of current smokers (61% vs. 17%, P < 0.01), and lower proportions taking aspirin and calcium antagonists (both 17% vs. 57%, P < 0.05) than the > 1-year group. In the < 1-year group, there were significant correlations between the low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) levels (r = 0.649, P = 0.004) and between the TG and hemoglobin (Hb)A1c levels (r = 0.552, P = 0.018), but these correlations were not observed a year before admission. TG level was the only parameter associated with LDL-C and HbA1c levels.

Conclusions: A linear correlation between the LDL-C and TG levels, obesity, older age, male sex, and smoking may be associated with increased risk of onset of ACS early after the initiation of statin therapy. Prospective cohort studies are needed to further explore these interactions.

No MeSH data available.


Related in: MedlinePlus