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Miura-Takahashi E, Tashiro K, Shiga Y, Kawahira Y, Kato Y, Kuwano T, Sugihara M, Otsu Y, Kamimura H, Miura SI. Association between pre-treatment with statin and its inhibitory effect on the onset of coronary artery disease at the time of coronary computed tomography angiography: a new look at an old medication. Heart Vessels 2024:10.1007/s00380-024-02407-4. [PMID: 38687349 DOI: 10.1007/s00380-024-02407-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 04/11/2024] [Indexed: 05/02/2024]
Abstract
Coronary artery stenosis is often advanced by the time coronary computed tomography angiography (CCTA). Statins are the most important anti-lipidemic medication for improving the prognosis of coronary artery disease (CAD) patients. Although lipid-lowering therapy using statins appears to have been established as a method for preventing CAD, there remains the problem that CAD cannot be completely suppressed. In this study, we investigated whether pre-treatment with statin could significantly inhibit the onset of CAD when patients received CCTA for screening of CAD. The subjects were 1164 patients who underwent CCTA as screening for CAD. CAD was diagnosed when 50% or more coronary stenosis was present in the coronary arteries. Patient backgrounds were investigated by age, gender, body mass index, coronary risk factors [family history of cardiovascular diseases, smoking history, hypertension (HTN), diabetes mellitus (DM), dyslipidemia, chronic kidney disease (CKD) or metabolic sydrome] and medications. Patients were classified into two groups according to the presence or absence of statin pre-administration during CCTA [statin (-) group (n = 804) and (+) group (n = 360)]. Compared with the statin (-) group, the statin (+) group was significantly older and had higher rates of family history, HTN, and DM. The statin (+) group had a significantly higher % CAD than the statin (-) group. Serum levels of low-density lipoprotein cholesterol (LDL-C) were significantly lower in the statin (+) group than in the statin (-) group. There was no significant difference in either high-density lipoprotein cholesterol levels or triglyceride levels between the two groups. Age, male gender, HTN, DM and pre-treatment with statin were all associated with CAD (+) in all patients. In addition, factors that contributed to CAD (+) in the statin (-) group were age, male gender, and DM, and factors that contributed to CAD (+) in the statin (+) group were age, smoking, HTN and % maximum dose of statin. At the time of CCTA, the statin (+) group had a high rate of CAD and coronary artery stenosis progressed despite a reduction of LDL-C levels. To prevent the onset of CAD, in addition to strict control of other coronary risk factors (HTN etc.), further LDL cholesterol-lowering therapy may be necessary.
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Affiliation(s)
- Erika Miura-Takahashi
- Department of Pharmacy, Fukuoka University Hospital, Fukuoka, Japan
- Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Kohei Tashiro
- Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan
- Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Yuhei Shiga
- Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan
- Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Yuto Kawahira
- Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan
- Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Yuta Kato
- Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan
- Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Takashi Kuwano
- Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan
- Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Makoto Sugihara
- Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan
- Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | - Yuki Otsu
- Department of Pharmacy, Fukuoka University Hospital, Fukuoka, Japan
- Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan
| | | | - Shin-Ichiro Miura
- Department of Cardiology, Fukuoka University Hospital, Fukuoka, Japan.
- Department of Cardiology, Fukuoka University School of Medicine, 7-45-1 Nanakuma, Jonan-ku, Fukuoka, 814-0180, Japan.
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Zhang M, Wu J, Wang Y, Wu J, Hu W, Jia H, Sun X. Associations between blood pressure levels and diabetic retinopathy in patients with diabetes mellitus: A population-based study. Heliyon 2023; 9:e16830. [PMID: 37484372 PMCID: PMC10360950 DOI: 10.1016/j.heliyon.2023.e16830] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 05/28/2023] [Accepted: 05/30/2023] [Indexed: 07/25/2023] Open
Abstract
Purpose To evaluate the associations of blood pressure levels with diabetic retinopathy (DR), proliferative diabetic retinopathy (PDR) and diabetic macular edema (DME) in patients with diabetes mellitus. Design A cross-sectional, population-based study. Subjects A total of 152,844 patients with diabetes from 90 major cities in 19 provincial regions of mainland China during 2018-2021 were finally recruited. Methods Blood pressure was graded into 5 levels: normal (without hypertension and <120/80 mmHg), normal high (without hypertension and ≥120/80 mmHg), HT-intensive (hypertension and <120/80 mmHg), HT-moderate (hypertension and blood pressure between 120/80 mmHg and 140/90 mmHg) and HT-high (hypertension and ≥140/90 mmHg). Logistic regression was employed to verify the associations of hypertension and blood pressure levels with DR, PDR and DME. The impacts of blood pressure levels on the outcomes were qualified with nomogram models. Main outcome measures The main outcome was DR. Results There were 16,685 (10.92%) participants having DR, 2841 (1.86%) having PDR, and 1566 (1.02%) having DME. There were 8126 (5.32%) patients without hypertension and 1350 (0.88%) patients with hypertension having blood pressure <120/80 mmHg. When compared to the normal group with covariates adjusted, an increased prevalence of DR was observed in normal high (adjusted odds ratio [OR] = 1.114, 95% confidence interval [CI] = 1.033-1.202), HT-moderate (adjusted OR = 1.163, 95% CI = 1.065-1.271), and HT-high (adjusted OR = 1.203, 95% CI = 1.114-1.300). Conclusions There were associations between hypertension and DR, PDR, and DME in the diabetic population. Increased prevalence of DR was found with blood pressure >120/80 mmHg in both patients with and without hypertension. A nomogram was developed for DR prediction based on blood pressure levels.
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Affiliation(s)
- Min Zhang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinye Wu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yimin Wang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Jiali Wu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Weiting Hu
- Shanghai Phoebus Medical Co. Ltd., Shanghai, China
| | - Huixun Jia
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
| | - Xiaodong Sun
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- National Clinical Research Center for Eye Diseases, Shanghai, China
- Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai, China
- Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai, China
- Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
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