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Effects of Statin Intensity on Long-term Outcomes After Coronary Artery Bypass Grafting

Yong Ho Jang1, Ki Hong Choi1, Young Bin Song1

  • 1Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.

The Annals of Thoracic Surgery
|September 23, 2021
PubMed

Insights

Higher intensity statins significantly reduce major adverse cardiac and cerebrovascular events (MACCE) after coronary artery bypass grafting (CABG). Moderate-intensity statin use is crucial for better long-term outcomes, particularly for acute coronary syndrome patients.

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Outcomes Research

Background:

  • Coronary artery bypass grafting (CABG) patients require optimal medical management to improve long-term outcomes.
  • Statin therapy is a cornerstone of cardiovascular disease prevention, but optimal intensity post-CABG remains under investigation.

Purpose of the Study:

  • To investigate the association between different statin intensities and long-term clinical outcomes in patients following CABG.
  • To determine if statin intensity influences major adverse cardiac and cerebrovascular events (MACCE) based on initial clinical presentation.

Main Methods:

  • A cohort of 6531 patients undergoing CABG was analyzed.
  • Patients were stratified into four groups based on statin intensity: no/low, lower-moderate, higher-moderate, and high-intensity.
  • Major adverse cardiac and cerebrovascular events (MACCE) at 5 years were the primary endpoint, analyzed using multivariate Cox and inverse probability weighting methods.

Main Results:

  • At least moderate-intensity statin use was linked to a significantly lower risk of 5-year MACCE compared to no or low-intensity statin use.
  • Higher-moderate and high-intensity statin use showed significantly lower MACCE risks than lower-moderate intensity statin use.
  • This benefit was particularly pronounced in CABG patients presenting with acute coronary syndrome, but not in those with stable ischemic heart disease.

Conclusions:

  • Lower-moderate intensity statin use (atorvastatin 10-mg equivalent) was associated with poorer long-term clinical outcomes post-CABG.
  • Higher-moderate or high-intensity statin use demonstrates superior outcomes, especially in acute coronary syndrome patients after CABG.
Abstract

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