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Sci Rep. 2023;13(1):16061.

New onset diabetes mellitus and cardiovascular outcomes according to statin intensity in patients after drug-eluting stent implantation in Asian patients.

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제1저자 정재훈, 김학령 · 교신저자 김상현

소속 (3)
  1. Division of Cardiology, Department of Internal Medicine, National Medical Center, Seoul, Republic of Korea.
  2. Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, 20, Boramae-Ro 5-Gil, Dongjak-Gu, Seoul, 07061, Republic of Korea.
  3. Division of Cardiology, Department of Internal Medicine, Boramae Medical Center, Seoul National University College of Medicine, 20, Boramae-Ro 5-Gil, Dongjak-Gu, Seoul, 07061, Republic of Korea. shkimheart@gmail.com.

Abstract

We investigated the effect of statin intensity on the development of new onset diabetes mellitus (NODM) in Korean patients after percutaneous coronary intervention (PCI). A total of 1013 consecutive patients without diabetes mellitus were retrospectively analyzed. All study patients received high- or moderate-intensity statin (high-intensity statin; 321 [31.7%], moderate-intensity statin; 692 [68.3%]). The primary endpoint was development of NODM, and the secondary one was the composite of cardiac death, non-fatal myocardial infarction, and any revascularization. In 264 pairs (528 patients) of propensity score-matched patient, NODM developed in 34 patients (6.4%) and composite cardiac events occurred in 73 patients (13.8%) during a median follow-up of 36.7 months. The incidence rate of NODM was significantly higher in patients with high-intensity statin than with moderate-intensity statin (8.3% vs. 4.5%, log-rank P = 0.026). The incidence rate of composite events was not significantly different between the two groups (12.5% vs.15.2%, log-rank P = 0.495). The use of high-intensity statins was associated with NODM after adjustment for multiple risk factors (adjusted hazard ratio, 2.18, 95% confidence interval 1.10‒4.51, P = 0.025). High-intensity statin therapy is associated with a higher incidence of NODM, but not with better cardiovascular outcomes, in Korean patients undergoing PCI. A new cholesterol lowering intensity-based approach rather than stain intensity-based approach to the high-risk patients without diabetes mellitus may be helpful in maximal treatment effect without safety concern of NODM in Asian patients.

© 2023. Springer Nature Limited.

Figures

Figure 1
Figure 1 Kaplan–Meier curves for 5-year clinical outcomes according to statin intensity in propensity-score matched population. (A) new onset diabetes mellitus, (B) composite of cardiac death or ischemia-driven any revascularization, (C) cardiac death, (D) myocardial infarction, (E) any revascularization.

그림 출처: PubMed Central 공개 논문 (PMC10520042)

Conflict of interest statement

The authors declare no competing interests.

그 밖의 정보
출판 형태
Journal Article
저널
Scientific reports · eISSN 2045-2322
전자 출판
2023-09-25
MeSH
Humans · Hydroxymethylglutaryl-CoA Reductase Inhibitors* / adverse effects · Drug-Eluting Stents* / adverse effects · Percutaneous Coronary Intervention* / adverse effects · Retrospective Studies · Diabetes Mellitus* / drug therapy / epidemiology
Substances
Hydroxymethylglutaryl-CoA Reductase Inhibitors
참고문헌
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