Endocrine Abstracts

JOINT2870

Background: The beneficial effect of moderate-intensity statin with ezetimibe combination therapy compared to high-intensity statin monotherapy in patients with angina pectoris undergoing percutaneous coronary intervention (PCI) remains unclear. We aimed to investigate the effect of moderate-intensity atorvastatin with ezetimibe combination therapy in patients with angina pectoris in real-world practice.

Methods: This retrospective cohort study used Korean National Health Insurance Database. A total of 6, 784 patients underwent PCI between 2015 and 2018 and received either moderate-intensity atorvastatin (10 and 20 mg) and ezetimibe 10mg (n = 4, 682) or high-intensity atorvastatin (40 and 80 mg; n = 2, 102). The primary outcome was a composite event of cardiovascular death, myocardial infarction, coronary revascularization, and stroke. The secondary outcome was newly developed diabetes. Subgroup analyses were performed based on baseline comorbidities.

Results: During the mean follow up of 4 years, the incidence rates of the primary outcome were 70. 14 vs. 62. 05 per 1, 000 person-years in the moderate-intensity atorvastatin and ezetimibe group and the high-intensity atorvastatin group, respectively. There were no significant differences in the risk of primary outcome between the moderate-intensity atorvastatin and ezetimibe group and the high-intensity atorvastatin group [hazard ratio (HR): 0. 99, 95% CI: 0. 90-1. 10]. The risk of new onset diabetes was not different between the two-treatment groups (HR: 0. 99, 95% CI: 0. 88-1. 13). However, in patients with underlying chronic kidney disease (CKD), moderate-intensity atorvastatin with ezetimibe combination therapy was associated with lower risk of primary outcome compared to the high intensity atorvastatin therapy (HR: 0. 40, 95% CI: 0. 18-0. 86).

Conclusion: In real-world cohort study, there was no significant difference in the cardiovascular outcome and new onset diabetes between moderate-intensity atorvastatin with ezetimibe combination therapy and high-intensity atorvastatin monotherapy in patients with angina pectoris undergoing PCI. Moderate-intensity atorvastatin with ezetimibe combination therapy may be beneficial particularly in patients with CKD.