Effectiveness of Statins on Lipid Goal Attainment and Lipid Parameters in PCI Patients
Effectiveness of Statins on Lipid Goal Attainment and Lipid Parameters in PCI Patients
Most PCI patients are at very high cardiovascular (CV) risk, and as such here is an increased
 need for intensive lipid management in Percutaneous Coronary Intervention (PCI) patients and
 the population is well suited to demonstrating rosuvastatin's low density
 lipoprotein-cholesterol (LDL-C) lowering efficacy.Most PCI patients are at very high CV risk,
 and as such here is an increased need for intensive lipid management in PCI patients and the
 population is well suited to demonstrating rosuvastatin's LDL-C lowering efficacy.The purpose
 of this study is to observe the effectiveness of statins on lipid level reduction (LDL-C,
 high density lipoprotein-cholesterol (HDL-C), Triglyceride (TG), and non-HDL-C) and lipid
 goal attainment according to recent guidelines.
The number of patients receiving Percutaneous Coronary Intervention (PCI) is rapidly
 increasing in China. In 2013, about 450,000 Chinese patients received PCI, most of whom
 suffered from coronary heart disease (CHD), especially acute coronary syndrome (ACS). ACS is
 associated with an increased risk of cardiovascular mortality and recurrent cardiac events,
 underscoring the importance of identifying treatments that minimize this risk.The Myocardial
 Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) trial suggested a benefit of
 lipid lowering with high-dose atorvastatin in patients with ACS. A meta-analysis of statin
 use in patients with ACS confirmed the benefits of early high-dose statin administration in
 decreasing recurrent myocardial ischemia, which suggested the clinical benefit and safety of
 statins were dose and statin dependent. The updated National Cholesterol Education Program
 Adult Treatment Panel III guidelines recommend that intensive therapy should be considered
 for all patients admitted to hospital for an ACS. Two meta-analyses have shown that early
 intensive statin therapy in patients with ACS is associated with a reduced rate of death and
 cardiovascular events. In the PROVE IT study, comparing atorvastatin 80 mg with pravastatin
 40 mg, a significant reduction in major adverse clinical events was observed in favour of
 more intensive statin treatment. In that study, the median concentration of low-density LDL-C
 was lowered from 106 mg/dL to 62 mg/dL in the atorvastatin 80 mg group. More recently, the
 2011 European Society of Cardiology (ESC)/ European Arterial Sclerosis Association (EAS)
 guideline for the management of dyslipidemia recommended patients with ACS are very high CV
 risk patients and should achieve LDL-C level <70 mg/dl or 50% reduction. In 2011 American
 College of Cardiology Foundation (ACCF) / American Heart Association (AHA) / (cardiovascular
 angiography and intervention Association)/ Association of Cardiovascular angiography and
 intervention (SCAI) Guideline for PCI, statin therapy which lowers LDL to <70mg/dL in very
 high-risk patients is recommended (IIa, B). The latest China ACS consensus also recommends
 using the highest dose statin treatment for the acute phase and to attain an LDL-C level of
 1.8 mmol/L or 50% reduction compared with baseline in long-term treatment. However, there are
 very limited Chinese data demonstrating the current situation of lipid management (LDL-C
 on-goal rate) by different statins in real-world clinical practice.

 Most PCI patients are at very high CV risk, and as such here is an increased need for
 intensive lipid management in PCI patients and the population is well suited to demonstrating
 rosuvastatin's LDL-C lowering efficacy.Most PCI patients are at very high CV risk, and as
 such here is an increased need for intensive lipid management in PCI patients and the
 population is well suited to demonstrating rosuvastatin's LDL-C lowering efficacy.The purpose
 of this study is to observe the effectiveness of statins on lipid level reduction (LDL-C,
 HDL-C, TG, and non-HDL-C) and lipid goal attainment according to recent guidelines.
Inclusion criteria:

 -  Patients must have had at least one treatment for statins, during the intake period
 (between 01/07/2011 and 31/01/2015). The date treated with statins after
 hospitalization before PCI or after PCI for statin naive patients, and date of PCI
 procedure for statin users will be marked as an index date.

 -  Patients must be 18 years or older at the time of index date.

 -  Patients must have at least 1 month of follow-up after the index date, including
 continuous statin treatment, lipid profile and lab values for safety profile.

 -  Patients must have at least two lab values: one full lipid panel prior to or on the
 index date, and one at least 30 days following the index date.

 Exclusion criteria:

 -  Patients with a diagnosis of Familial Hypercholesterolemia.

 -  Patients with malignant tumor at the index day.