Comparison of High-Statin Therapy vs Moderate-Statin Therapy in Achieving Positive Low-Density Lipoprotein Change in Patients After Acute Coronary Syndrome: A Randomized-Control Trial.

Chamithra D Rupasinghe,Rohail Sani,Natalia M Avendaño Capriles,Camilo Andrés Avendaño Capriles,Theodosios Kantas,Afreenish Gul,Sohaib Tousif,Ramil Dadabhoy,Noman Khurshid Ahmed

doi:10.7759/cureus.20710

Abstract

Introduction: Statin use in secondary prevention after acute coronary syndrome (ACS) can play an important role in enhancing clinical outcomes, this has been proven in several randomized trials. This study was conducted to compare the efficacy of moderate-intensity and high-intensity statins in controlling low-density lipoprotein (LDL) after ACS.Methodology: A randomized control trial was conducted at the Cardiology Department of Liaquat National Hospital, Karachi, Pakistan, from July 2020 to September 2021. During admission, patients were either started on a high-intensity statin dose (rosuvastatin 20 mg) or moderate-intensity statin (rosuvastatin 10 mg) by a computer-generated allocation sequence. Patients were followed-up in the outpatient department (OPD) after 3 months, and a lipid profile at follow-up was obtained. The percentage of LDL change was determined on 3 months of follow-up.Results: A total of 590 patients were enrolled in the study. Out of all participants enrolled, 334 (80.48%) completed the 3-month follow-up. The mean age of participants was 58.08 (+12.06) years. High-intensity statin therapy is positively associated with positive LDL change (adjusted odds ratio [AOR]=4.45, P-value=0.001).Conclusion: Our data implies that high-intensity statin medication may be an initial therapeutic option to decrease LDL. However, future randomized clinical trials should corroborate these findings.

Highlights

Statin use in secondary prevention after acute coronary syndrome (ACS) can play an important role in enhancing clinical outcomes, this has been proven in several randomized trials
High-intensity statin therapy is positively associated with positive lowdensity lipoprotein (LDL) change
Categories: Cardiac/Thoracic/Vascular Surgery, Cardiology, Family/General Practice Keywords: moderate-statin therapy, high-statin therapy, cardiac, acute coronary syndrome, ldl Statin use after acute coronary syndrome (ACS) can play an important role in enhancing clinical outcomes, and this has been proven in several randomized trials [1,2]

Summary

Introduction

Statin use in secondary prevention after acute coronary syndrome (ACS) can play an important role in enhancing clinical outcomes, this has been proven in several randomized trials. This study was conducted to compare the efficacy of moderate-intensity and high-intensity statins in controlling lowdensity lipoprotein (LDL) after ACS. Statin use after acute coronary syndrome (ACS) can play an important role in enhancing clinical outcomes, and this has been proven in several randomized trials [1,2]. Studies have shown that the East Asian population has lower baseline low-density lipoprotein cholesterol (LDL-C), better statin responsiveness, and greater susceptibility to statin therapy side effects than the Western population [5]. A recent randomized trial in an East Asian population failed to demonstrate the incremental clinical effectiveness of high-intensity statin medication [6]. One trial found that Asians who achieved a less modern LDL-C target of 70 mg/dl benefited from high-intensity statins [11]

Methods

Results

Discussion

Conclusion