Effects of High- or Moderate-intensity Rosuvastatin on 1-year Major Adverse Cardiovascular Events Post-percutaneous Coronary Intervention

Abstract

Background: Although statins decrease mortality in coronary artery disease, the effect of high-dose statins and duration of therapy post-percutaneous coronary intervention (PCI) is not well addressed. Aim: To determine the effective dose of statin to prevent major adverse cardiovascular events (MACEs), such as acute coronary syndrome, stroke, myocardial infarction, revascularisation and cardiac death, after PCI in patients with chronic coronary syndrome. Methods: In this randomised, double-blind clinical trial, all chronic coronary syndrome patients with a recent history of PCI were randomly divided into two groups after 1 month of high-dose rosuvastatin therapy. Over the next year, the first group received rosuvastatin 5 mg daily (moderate intensity), while the second received rosuvastatin 40 mg daily (high intensity). Participants were evaluated in terms of high-sensitivity C-reactive protein and MACEs. Results: The 582 eligible patients were divided into group 1 (n=295) and group 2 (n=287). There was no significant difference between the two groups in terms of sex, age, hypertension, diabetes, smoking, previous history of PCI or history of coronary artery bypass grafting (p>0.05). There were no statistically significant differences in MACE and high-sensitivity C-reactive protein after 1 year between the two groups (p=0.66). Conclusion: The high-dose group had lower LDL levels. However, given the lack of association between high-intensity statins and MACEs in the first year after PCI among chronic coronary syndrome patients, the use of moderate-intensity statins may be as effective as high-intensity statins, and treatment based on LDL targets may suffice.