The impact of pravastatin therapy on long-term outcome in patients with metabolic syndrome undergoing complete coronary revascularization.
BACKGROUND
Few studies dealing with the efficacy of statin therapy among patients with metabolic syndrome (MS) and coronary artery disease (CAD) have been conducted. In particular, there have been no studies of the efficacy of statins among Asian MS patients with treated CAD.


RESULTS
Data from 1,138 consecutive patients who underwent complete revascularization (coronary intervention or bypass surgery) were collected. Of these, 529 patients who satisfied the criteria for MS using the American Heart Association/National Heart, Lung and Blood Institute statement (body mass index >or=25 was used instead of waist circumference) were assessed. All-cause and cardiovascular mortality of patients given statins and those not given statins at least 2 weeks before the complete revascularization were compared. To adjust for the variables that would have been related to the decision to give statins, the propensity score was calculated, and multivariate Cox regression was carried out. Statins were given to 146 patients. During follow-up (9.1 +/-2.5 years), 104 patients died. On multivariate analysis, statin use was significantly associated with reduced all-cause (hazard ratio (HR) 0.56, 0.31-0.99; P=0.049) and cardiovascular (HR 0.53, 0.30-0.96; P=0.042) mortality.


CONCLUSIONS
In patients with MS and CAD, statins given at least 2 weeks before the complete revascularization, was associated with a reduced risk of all-cause and cardiovascular mortality.
Kasai
Takatoshi
T
Department of Cardiology, Juntendo University, School of Medicine, Tokyo, Japan.
Miyauchi
Katsumi
K
Kajimoto
Kan
K
Kubota
Naozumi
N
Kurata
Takeshi
T
Amano
Atsushi
A
Daida
Hiroyuki
H
D000368:Aged; D044466:Asian People; D003324:Coronary Artery Disease / Q000188:drug therapy* / Q000209:etiology / Q000401:mortality / Q000601:surgery*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007564:Japan / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D024821:Metabolic Syndrome / Q000150:complications* / Q000188:drug therapy*; D008875:Middle Aged; D009204:Myocardial Revascularization; D017035:Pravastatin / Q000627:therapeutic use*; D016016:Proportional Hazards Models; D012307:Risk Factors; D013997:Time Factors; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D017035:Pravastatin