Treat-to-Target or High-Intensity Statin in Patients With Coronary Artery Disease A Randomized Clinical Trial
DC Field | Value | Language |
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dc.contributor.author | Hong, Sung-Jin | - |
dc.contributor.author | Lee, Yong-Joon | - |
dc.contributor.author | Lee, Seung-Jun | - |
dc.contributor.author | Hong, Bum-Kee | - |
dc.contributor.author | Kang, Woong Chol | - |
dc.contributor.author | Lee, Jong-Young | - |
dc.contributor.author | Lee, Jin-Bae | - |
dc.contributor.author | Yang, Tae-Hyun | - |
dc.contributor.author | Yoon, Junghan | - |
dc.contributor.author | Ahn, Chul-Min | - |
dc.contributor.author | Kim, Jung-Sun | - |
dc.contributor.author | Kim, Byeong-Keuk | - |
dc.contributor.author | Ko, Young-Guk | - |
dc.contributor.author | Choi, Donghoon | - |
dc.contributor.author | Jang, Yangsoo | - |
dc.contributor.author | Hong, Myeong-Ki | - |
dc.date.accessioned | 2023-06-11T01:40:32Z | - |
dc.date.available | 2023-06-11T01:40:32Z | - |
dc.date.created | 2023-03-26 | - |
dc.date.issued | 2023-04 | - |
dc.identifier.issn | 0098-7484 | - |
dc.identifier.uri | https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/88045 | - |
dc.description.abstract | IMPORTANCE In patients with coronary artery disease, some guidelines recommend initial statin treatment with high-intensity statins to achieve at least a 50% reduction in low-density lipoprotein cholesterol (LDL-C). An alternative approach is to begin with moderate-intensity statins and titrate to a specific LDL-C goal. These alternatives have not been compared head-to-head in a clinical trial involving patients with known coronary artery disease.OBJECTIVE To assess whether a treat-to-target strategy is noninferior to a strategy of high-intensity statins for long-term clinical outcomes in patients with coronary artery disease.DESIGN, SETTING, AND PARTICIPANTS A randomized, multicenter, noninferiority trial in patients with a coronary disease diagnosis treated at 12 centers in South Korea (enrollment: September 9, 2016, through November 27, 2019; final follow-up: October 26, 2022).INTERVENTIONS Patients were randomly assigned to receive either the LDL-C target strategy, with an LDL-C level between 50 and 70 mg/dL as the target, or high-intensity statin treatment, which consisted of rosuvastatin, 20 mg, or atorvastatin, 40 mg.MAIN OUTCOMES AND MEASURES Primary end point was a 3-year composite of death, myocardial infarction, stroke, or coronary revascularization with a noninferiority margin of 3.0 percentage points.RESULTS Among 4400 patients, 4341 patients (98.7%) completed the trial (mean [SD] age, 65.1 [9.9] years; 1228 females [27.9%]). In the treat-to-target group (n = 2200), which had 6449 person-years of follow-up, moderate-intensity and high-intensity dosing were used in 43% and 54%, respectively. The mean (SD) LDL-C level for 3 years was 69.1 (17.8) mg/dL in the treat-to-target group and 68.4 (20.1) mg/dL in the high-intensity statin group (n = 2200) (P = .21, compared with the treat-to-target group). The primary end point occurred in 177 patients (8.1%) in the treat-to-target group and 190 patients (8.7%) in the high-intensity statin group (absolute difference, -0.6 percentage points [upper boundary of the 1-sided 97.5% CI, 1.1 percentage points]; P < .001 for noninferiority).CONCLUSIONS AND RELEVANCE Among patients with coronary artery disease, a treat-to-target LDL-C strategy of 50 to 70 mg/dL as the goal was noninferior to a high-intensity statin therapy for the 3-year composite of death, myocardial infarction, stroke, or coronary revascularization. These findings provide additional evidence supporting the suitability of a treat-to-target strategy that may allow a tailored approach with consideration for individual variability in drug response to statin therapy. | - |
dc.language | 영어 | - |
dc.language.iso | en | - |
dc.publisher | AMER MEDICAL ASSOC | - |
dc.relation.isPartOf | JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | - |
dc.title | Treat-to-Target or High-Intensity Statin in Patients With Coronary Artery Disease A Randomized Clinical Trial | - |
dc.type | Article | - |
dc.type.rims | ART | - |
dc.description.journalClass | 1 | - |
dc.identifier.wosid | 000946807900001 | - |
dc.identifier.doi | 10.1001/jama.2023.2487 | - |
dc.identifier.bibliographicCitation | JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, v.329, no.13, pp.1078 - 1087 | - |
dc.description.isOpenAccess | Y | - |
dc.identifier.scopusid | 2-s2.0-85152169562 | - |
dc.citation.endPage | 1087 | - |
dc.citation.startPage | 1078 | - |
dc.citation.title | JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | - |
dc.citation.volume | 329 | - |
dc.citation.number | 13 | - |
dc.contributor.affiliatedAuthor | Kang, Woong Chol | - |
dc.type.docType | Article | - |
dc.subject.keywordPlus | MYOCARDIAL-INFARCTION | - |
dc.subject.keywordPlus | DYSLIPIDEMIA | - |
dc.subject.keywordPlus | MANAGEMENT | - |
dc.subject.keywordPlus | ATORVASTATIN | - |
dc.subject.keywordPlus | ASSOCIATION | - |
dc.subject.keywordPlus | GUIDELINES | - |
dc.subject.keywordPlus | RECOMMENDATIONS | - |
dc.subject.keywordPlus | METAANALYSIS | - |
dc.subject.keywordPlus | CHOLESTEROL | - |
dc.subject.keywordPlus | PREVENTION | - |
dc.relation.journalResearchArea | General & Internal Medicine | - |
dc.relation.journalWebOfScienceCategory | Medicine, General & Internal | - |
dc.description.journalRegisteredClass | scie | - |
dc.description.journalRegisteredClass | scopus | - |
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