title: Cross-sectional study of patients with onset of acute coronary syndrome during statin therapy.
abstract: BACKGROUND
  Although statin therapy significantly reduces cardiovascular morbidity and mortality, atherosclerotic plaque progresses in some patients taking statins. This study investigated the factors associated with onset of acute coronary syndrome (ACS) early after the initiation of statin therapy.
  
  
  METHODS
  Consecutive patients taking statins who presented with ACS (n = 64) were divided into < 1-year and > 1-year groups based on the duration of statin therapy. Patient characteristics, coronary risk factors, lesion locations, and percutaneous intervention procedures were compared between groups.
  
  
  RESULTS
  The < 1-year group was significantly younger (57.6 ± 11.9 years vs. 76.6 ± 9.1 years, P < 0.01), had significantly higher body mass index (27.22 ± 4.20 kg/m(2) vs. 24.60 ± 4.65 kg/m(2), P < 0.05), higher proportion of males (94% vs. 70%, P < 0.05), higher proportion of current smokers (61% vs. 17%, P < 0.01), and lower proportions taking aspirin and calcium antagonists (both 17% vs. 57%, P < 0.05) than the > 1-year group. In the < 1-year group, there were significant correlations between the low-density lipoprotein cholesterol (LDL-C) and triglyceride (TG) levels (r = 0.649, P = 0.004) and between the TG and hemoglobin (Hb)A1c levels (r = 0.552, P = 0.018), but these correlations were not observed a year before admission. TG level was the only parameter associated with LDL-C and HbA1c levels.
  
  
  CONCLUSIONS
  A linear correlation between the LDL-C and TG levels, obesity, older age, male sex, and smoking may be associated with increased risk of onset of ACS early after the initiation of statin therapy. Prospective cohort studies are needed to further explore these interactions.
authors.affiliation: Department of Internal Medicine, Gunma Chuo Hospital, 1-7-13 Koun-cho, Maebashi, Gunma 371-0025, Japan.
authors.forename: Nobuhiro
authors.initials: N
authors.lastname: Akuzawa
authors.affiliation: Department of Internal Medicine, Gunma Chuo Hospital, 1-7-13 Koun-cho, Maebashi, Gunma 371-0025, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Hatori
authors.affiliation: Department of Internal Medicine, Gunma Chuo Hospital, 1-7-13 Koun-cho, Maebashi, Gunma 371-0025, Japan.
authors.forename: Kunihiko
authors.initials: K
authors.lastname: Imai
authors.affiliation: Department of Internal Medicine, Gunma Chuo Hospital, 1-7-13 Koun-cho, Maebashi, Gunma 371-0025, Japan.
authors.forename: Yonosuke
authors.initials: Y
authors.lastname: Kitahara
authors.affiliation: Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, 3-39-22 Showa-machi, Maebashi, Gunma 371-8511, Japan.
authors.forename: Masahiko
authors.initials: M
authors.lastname: Kurabayashi
keywords: Acute coronary syndrome; Low-density lipoprotein cholesterol; Statin; Triglyceride