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Prognostic implications of statin intolerance in stable coronary artery disease patients with different levels of high-sensitive troponin

BACKGROUND: The prognostic implication of statin in tolerance (SI) in those with stable CAD remains unclear. We hypothesized that SI is of higher prognostic significance in stable CAD patients with elevated high-sensitive cardiac troponin I (hs-cTnI). METHODS: A total of 952 stable CAD patients from...

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Autores principales: Hai, Jo-Jo, Wong, Yuen-Kwun, Wong, Chun-Ka, Un, Ka-Chun, Chan, Pak-Hei, Siu, Chung-Wah, Yiu, Kai-Hang, Lau, Chu-Pak, Tse, Hung-Fat
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6633694/
https://www.ncbi.nlm.nih.gov/pubmed/31307391
http://dx.doi.org/10.1186/s12872-019-1152-x
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author Hai, Jo-Jo
Wong, Yuen-Kwun
Wong, Chun-Ka
Un, Ka-Chun
Chan, Pak-Hei
Siu, Chung-Wah
Yiu, Kai-Hang
Lau, Chu-Pak
Tse, Hung-Fat
author_facet Hai, Jo-Jo
Wong, Yuen-Kwun
Wong, Chun-Ka
Un, Ka-Chun
Chan, Pak-Hei
Siu, Chung-Wah
Yiu, Kai-Hang
Lau, Chu-Pak
Tse, Hung-Fat
author_sort Hai, Jo-Jo
collection PubMed
description BACKGROUND: The prognostic implication of statin in tolerance (SI) in those with stable CAD remains unclear. We hypothesized that SI is of higher prognostic significance in stable CAD patients with elevated high-sensitive cardiac troponin I (hs-cTnI). METHODS: A total of 952 stable CAD patients from the prospective Hong Kong CAD study who had complete clinical data, biomarker measurements and who were prescribed statin therapy were studied. RESULTS: We identified 13 (1.4%) and 125 (13.1%) patients with complete and partial SI, respectively. At baseline, patients with SI were more likely to have diabetes mellitus and a higher hs-cTnI level, but no difference in LDL-C level compared with those without SI. After 51 months of follow-up, patients with SI had a higher mean LDL-C level than those without SI. A total of 148 (15.5%) patients developed major adverse cardiovascular events (MACEs). Both SI (HR 1.52, 95% CI 1.06–2.19, P = 0.02) and elevated hs-cTnI (HR 3.18, 95% CI 2.07–4.89, P < 0.01) were independent predictors of a MACE in patients with stable CAD. When stratified by hs-cTnI level, SI independently predicted MACE-free survival only in those with elevated hs-cTnI (HR 1.51, 95% CI 1.01–2.24, P = 0.04). CONCLUSIONS: SI independently predicted MACE in patients with stable CAD and high hs-cTnI, but not in those with low hs-cTnI. Hs-cTnI may be used to stratify stable CAD patients who have SI for intensive lipid-lowering therapy using non-statin agents. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12872-019-1152-x) contains supplementary material, which is available to authorized users.
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spelling pubmed-66336942019-07-25 Prognostic implications of statin intolerance in stable coronary artery disease patients with different levels of high-sensitive troponin Hai, Jo-Jo Wong, Yuen-Kwun Wong, Chun-Ka Un, Ka-Chun Chan, Pak-Hei Siu, Chung-Wah Yiu, Kai-Hang Lau, Chu-Pak Tse, Hung-Fat BMC Cardiovasc Disord Research Article BACKGROUND: The prognostic implication of statin in tolerance (SI) in those with stable CAD remains unclear. We hypothesized that SI is of higher prognostic significance in stable CAD patients with elevated high-sensitive cardiac troponin I (hs-cTnI). METHODS: A total of 952 stable CAD patients from the prospective Hong Kong CAD study who had complete clinical data, biomarker measurements and who were prescribed statin therapy were studied. RESULTS: We identified 13 (1.4%) and 125 (13.1%) patients with complete and partial SI, respectively. At baseline, patients with SI were more likely to have diabetes mellitus and a higher hs-cTnI level, but no difference in LDL-C level compared with those without SI. After 51 months of follow-up, patients with SI had a higher mean LDL-C level than those without SI. A total of 148 (15.5%) patients developed major adverse cardiovascular events (MACEs). Both SI (HR 1.52, 95% CI 1.06–2.19, P = 0.02) and elevated hs-cTnI (HR 3.18, 95% CI 2.07–4.89, P < 0.01) were independent predictors of a MACE in patients with stable CAD. When stratified by hs-cTnI level, SI independently predicted MACE-free survival only in those with elevated hs-cTnI (HR 1.51, 95% CI 1.01–2.24, P = 0.04). CONCLUSIONS: SI independently predicted MACE in patients with stable CAD and high hs-cTnI, but not in those with low hs-cTnI. Hs-cTnI may be used to stratify stable CAD patients who have SI for intensive lipid-lowering therapy using non-statin agents. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12872-019-1152-x) contains supplementary material, which is available to authorized users. BioMed Central 2019-07-15 /pmc/articles/PMC6633694/ /pubmed/31307391 http://dx.doi.org/10.1186/s12872-019-1152-x Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Hai, Jo-Jo
Wong, Yuen-Kwun
Wong, Chun-Ka
Un, Ka-Chun
Chan, Pak-Hei
Siu, Chung-Wah
Yiu, Kai-Hang
Lau, Chu-Pak
Tse, Hung-Fat
Prognostic implications of statin intolerance in stable coronary artery disease patients with different levels of high-sensitive troponin
title Prognostic implications of statin intolerance in stable coronary artery disease patients with different levels of high-sensitive troponin
title_full Prognostic implications of statin intolerance in stable coronary artery disease patients with different levels of high-sensitive troponin
title_fullStr Prognostic implications of statin intolerance in stable coronary artery disease patients with different levels of high-sensitive troponin
title_full_unstemmed Prognostic implications of statin intolerance in stable coronary artery disease patients with different levels of high-sensitive troponin
title_short Prognostic implications of statin intolerance in stable coronary artery disease patients with different levels of high-sensitive troponin
title_sort prognostic implications of statin intolerance in stable coronary artery disease patients with different levels of high-sensitive troponin
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6633694/
https://www.ncbi.nlm.nih.gov/pubmed/31307391
http://dx.doi.org/10.1186/s12872-019-1152-x
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