title: Comparison of preventive effect on cardiovascular events with different statins. -The CIRCLE study-.
abstract: BACKGROUND
  Although statins vary in their effectiveness in lowering low-density lipoprotein cholesterol (LDL-C) and increasing high-density lipoprotein cholesterol (HDL-C) levels, there is little evidence that the degree of these changes can explain cardiac risk reduction in Japan. Our objective was to compare the efficacy of statins on serum lipid levels and to explore the association between those changes and cardiac events in patients after percutaneous coronary intervention (PCI).
  
  
  RESULTS
  The 743 consecutive patients who underwent PCI from 2001 to 2008 were retrospectively investigated. Treatment with either atorvastatin or pitavastatin significantly reduced LDL-C compared with pravastatin or no statin. In contrast, only pitavastatin treatment significantly increased HDL-C (13.4 ± 22.9%, P=0.01 vs. no statin). Each statin significantly prevented major adverse cardiac events (MACE) compared with no statin, and pitavastatin was the most effective of all. Multivariate-adjusted analysis revealed that percent changes of both LDL-C and HDL-C independently predicted the incidence of MACE (hazard ratio [HR]: 1.015; 95% confidence interval [CI]: 1.010-1.020, HR: 0.988; 95%CI: 0.981-0.996, respectively). This relationship was preserved in patients with a baseline HDL-C level ≤ 45 mg/dl, but not HDL-C level > 45 mg/ml.
  
  
  CONCLUSIONS
  The extent of changes in LDL-C and HDL-C with statin treatment would independently alter the risk of cardiac events in Japanese patients for secondary prevention. Statins with varying lipid-modifying ability might provide differing prognosis in patients after PCI.
authors.affiliation: Department of Cardiology, Kawasaki Hospital, Kobe, Japan. cj@j-circ.or.jp
authors.forename: Takao
authors.initials: T
authors.lastname: Maruyama
authors.forename: Masanori
authors.initials: M
authors.lastname: Takada
authors.forename: Yoshiharu
authors.initials: Y
authors.lastname: Nishibori
authors.forename: Kouichi
authors.initials: K
authors.lastname: Fujita
authors.forename: Koujirou
authors.initials: K
authors.lastname: Miki
authors.forename: Shigeki
authors.initials: S
authors.lastname: Masuda
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Horimatsu
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Hasuike
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000009:adverse effects*; D044466:Asian People; D000069059:Atorvastatin; D002318:Cardiovascular Diseases / Q000097:blood / Q000517:prevention & control; D008076:Cholesterol, HDL / Q000097:blood*; D008078:Cholesterol, LDL / Q000097:blood*; D005260:Female; D006538:Heptanoic Acids / Q000008:administration & dosage*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D007564:Japan; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood / Q000517:prevention & control; D011758:Pyrroles / Q000008:administration & dosage*; D011804:Quinolines / Q000008:administration & dosage*; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D011804:Quinolines; D000069059:Atorvastatin; C108475:pitavastatin