AUTHOR=Ng Andrew Kei-Yan , Ng Pauline Yeung , Ip April , Siu Chung-Wah 

TITLE=High-Intensity Statin vs. Low-Density Lipoprotein Cholesterol Target for Patients Undergoing Percutaneous Coronary Intervention: Insights From a Territory-Wide Cohort Study in Hong Kong

JOURNAL=Frontiers in Cardiovascular Medicine

VOLUME=Volume 8 - 2021

YEAR=2021

URL=https://www.frontiersin.org/journals/cardiovascular-medicine/articles/10.3389/fcvm.2021.760926

DOI=10.3389/fcvm.2021.760926

ISSN=2297-055X

ABSTRACT=Background: Different guidelines recommend different approaches to lipid management in patients with atherosclerotic cardiovascular disease. We aim to determine the best strategy for lipid management in Asian patients undergoing percutaneous coronary intervention (PCI).
Method: This was a retrospective cohort study conducted in patients who underwent first-ever (PCI) from 14 hospitals in Hong Kong. All participants either achieved low density lipoprotein cholesterol (LDL-C) target of <55 mg/dL with ≥50% reduction from baseline (group 1), or received high intensity statin (group 2), or both (group 3) within 1 year after PCI. The primary endpoint was a composite outcome of all-cause mortality, myocardial infarction, stroke and any unplanned coronary revascularization between 1 to 5 years after PCI. 
Results: A total of 8,650 patients were analysed with a median follow up period of 4.2 years. After adjustment of baseline characteristics, complexity of PCI and medications prescribed, the risks of the primary outcome were significantly lower in group 2 (hazard ratio [HR], 0.82; 95% confidence interval [CI], 0.74 to 0.93, P=0.003), and group 3 (HR, 0.75; 95% CI, 0.62-0.90; P=0.002). The primary outcome occurred at similar rates between group 2 and group 3. 
Conclusions: Use of high intensity statin, with or without attainment of guideline recommended LDL-C target, was associated with a lower adjusted risk of MACE at 5 years, compared with patients who attained LDL-C target without high intensity statin.