J Lipid Atheroscler.  2015 Jun;4(1):27-34. 10.12997/jla.2015.4.1.27.

Dyslipidemia and Lipid-Lowering in Patients with High Risk of Cardiovascular Diseases and Their Cardiovascular Outcomes in Korea (ENSURE study): Secondary Prevention in Chronic Stable Angina

• Park KT
• Ahn SG
• Jo SH
• Park S
• Kang HJ
• Kim KI
• Kim KH
• Yang DH
• Kim SH
• Han KH
• Lee IK

• KMID: 2005732
• DOI: http://doi.org/10.12997/jla.2015.4.1.27

Abstract

BACKGROUND AND OBJECTIVES
The aim of this study was to investigate the status of LDL-cholesterol level and its relationship with subsequent cardiovascular events in Korean patients with chronic stable angina.
METHODS
The patients with stable angina were retrospectively and consecutively enrolled from out-patients clinic during 2007-2009. Mean follow-up duration was 3 years. Occurrences of major adverse cardio-cerebrovascular event (MACCE: a composite of death, myocardial infarction, unstable angina, coronary revascularization, cerebrovascular events, peripheral artery disease and aortic disease requiring hospital admission.) were compared by initial LDL-cholesterol levels using Cox proportional-hazards model.
RESULTS
1,683 subjects were enrolled from 9 hospitals. Initial median LDL-cholesterol by tertile was 62.2, 90.2, and 124.0mg/dL respectively, however, the differences in LDL-cholesterol level among initial 3 tertile groups became narrow at 3rd year (67.8, 85.0, and 91.6mg/dL, respectively). MACCE occurred in 138 (8.2%) subjects, including 127 coronary events, 9 cerebrovascular events and 2 peripheral artery disease during the 3-year follow-up. The adjusted hazard ratio for MACCE was 1.02 (95% confidence interval 0.64-1.64) in the middle tertile of LDL-cholesterol, 1.53 (p=0.063, 95% Confidence Interval 0.98-2.40) in the highest tertile of LDL-cholesterol. The newly diagnosed diabetes mellitus was more frequent in subjects with statin treatment than subjects without statin during the 3-year follow-up (1.5% vs 0.6%).
CONCLUSION
Increased cardiovascular risk was observed in angina patients with higher initial LDL-cholesterol levels during the 3-year follow-up, although the differences were statistically insignificant.

Keyword

Angina; Hypercholesterolemia; Secondary prevention; Korean

MeSH Terms

Angina, Stable*
Angina, Unstable
Aortic Diseases
Cardiovascular Diseases*
Diabetes Mellitus
Dyslipidemias*
Follow-Up Studies
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
Hypercholesterolemia
Korea
Myocardial Infarction
Outpatients
Peripheral Arterial Disease
Retrospective Studies
Secondary Prevention*

Figure

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  Fig. 1 Serial changes of LDL-C levels in each group by baseline LDL-C during follow-up

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