Comparative Analysis of High-Intensity versus Low-to-Moderate Intensity Statin Therapy in Patients Undergoing Rotational Atherectomy for Calcified Coronary Artery Disease
Sang-Suk Choi,
Jin Jung,
Sung-Ho Her,
Kyunyeon Kim,
Youngmin Kim,
Kyusup Lee,
Ki-Dong Yoo,
Keon-Woong Moon,
Donggyu Moon,
Su-Nam Lee,
Won-Young Jang,
Ik-Jun Choi,
Jae-Hwan Lee,
Jang-Hoon Lee,
Sang-Rok Lee,
Seung-Whan Lee,
Kyeong-Ho Yun,
Hyun-Jong Lee
Affiliations
Sang-Suk Choi
Department of Cardiology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 16247, Republic of Korea
Jin Jung
Department of Cardiology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 16247, Republic of Korea
Sung-Ho Her
Department of Cardiology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 16247, Republic of Korea
Kyunyeon Kim
Department of Cardiology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 16247, Republic of Korea
Youngmin Kim
Department of Cardiology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 16247, Republic of Korea
Kyusup Lee
Department of Cardiology, Daejeon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 34943, Republic of Korea
Ki-Dong Yoo
Department of Cardiology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 16247, Republic of Korea
Keon-Woong Moon
Department of Cardiology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 16247, Republic of Korea
Donggyu Moon
Department of Cardiology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 16247, Republic of Korea
Su-Nam Lee
Department of Cardiology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 16247, Republic of Korea
Won-Young Jang
Department of Cardiology, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Seoul 16247, Republic of Korea
Ik-Jun Choi
Department of Cardiology, Incheon St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Incheon 21431, Republic of Korea
Jae-Hwan Lee
Department of Cardiology in Internal Medicine, Chungnam National University School of Medicine, Chungnam National University Sejong Hospital, Sejong 30099, Republic of Korea
Jang-Hoon Lee
Department of Internal Medicine, Kyungpook National University Hospital, Daegu 41944, Republic of Korea
Sang-Rok Lee
Department of Cardiology, Jeonbuk National University Hospital, Jeonju 54907, Republic of Korea
Seung-Whan Lee
Department of Cardiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul 05505, Republic of Korea
Kyeong-Ho Yun
Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan 54538, Republic of Korea
Hyun-Jong Lee
Department of Internal Medicine, Sejong General Hospital, Bucheon 14754, Republic of Korea
(1) Background: Moderate-intensity statin therapy, when compared to high-intensity statin therapy in Asian populations, has shown no significant difference in cardiovascular prognosis in small studies. The aim of this study was to compare the prognosis of patients based on statin intensity following rotational atherectomy (RA) during high-complexity percutaneous coronary intervention (PCI). (2) Methods: The ROCK registry, a multicenter retrospective study, included patients who had undergone rotational atherectomy (RA) during percutaneous coronary intervention (PCI) at nine tertiary medical centers in South Korea between January 2010 and October 2019. The patients were divided into high-intensity statin (H-statin) and moderate/low-intensity statin (M/L-statin) therapy groups. The primary endpoint includes outcomes (cardiac death, target vessel myocardial infarction (MI), and target vessel revascularization (TVR)) within an 18-month follow-up period. (3) Results: In this registry, a total of 540 patients with 583 lesions were included. We excluded 39 lesions from the analysis due to the absence of statin usage. The H-statin group had 394 lesions and the M/L-statin group had 150 lesions. There were no significant differences in baseline characteristics, procedural adverse events without heart failure history, triglycerides, or medications between the two groups. The procedural success rate showed a significant difference between the two groups. Multivariate analysis did not show a significant association between M/L-statin therapy and an increased risk of the primary endpoint. In propensity score matching analysis, no significant difference was observed in the primary endpoint either. (4) Conclusions: In high-complex RA PCI, moderate/low-intensity statin therapy is not inferior to high-intensity statin therapy in Korea.
