Interaction Between Statin Use, Coronary Artery Disease Phenotypes, on Computed Tomography Angiography, and Cardiovascular Outcomes
Authors' conclusion
Statin efficacy to decrease MACE depends on CAD phenotypes and increases with the extent and severity of disease and in the presence of high-risk plaques. Patients without CAD have no benefit from statin therapy regarding MACE.
Study context
- Population
- Consecutive patients referred for coronary computed tomography angiography (CTA) for chronic coronary syndrome at a tertiary centre, 2013–2020
- Participants
- 11,026 patients
- Exposure
- Statin use across coronary artery disease (CAD) phenotypes on coronary CTA
- Outcome
- Major adverse cardiac events (MACE):
- All-cause mortality
- Acute MI
- Revascularization for unstable angina
Methodological detailssingle-centre, consecutive patients, interaction analysis
- Single-centre
- Consecutive patients
- Interaction analysis
Main finding
As reported in the abstract
MACE per 10% increase in statin use
Adjusted hazard ratio (95% CI)P value
CAD
0.95(0.92–0.99)
P = 0.006No CAD
0.95(0.84–1.07)
P = 0.370Per 10% increase in statin use, as printed
Observational data: associations, not effects.
Further findings
| Outcome | aHR (95% CI) | P value | |
|---|---|---|---|
| MACE per 10% increase in statin use, by CAD phenotype (interaction analysis, total population) — Obstructive CAD · interaction analysis | 0.91 (0.85–0.97) | P = 0.006 | |
| MACE per 10% increase in statin use, by CAD phenotype (interaction analysis, total population) — High-risk plaque · interaction analysis | 0.82 (0.68–0.98) | P = 0.026 | |
| MACE per 10% increase in statin use, by CAD phenotype (interaction analysis, total population) — Calcium score ≥400 · interaction analysis | 0.93 (0.87–0.99) | P = 0.024 | |
| MACE per 10% increase in statin use, by CAD phenotype (interaction analysis, total population) — Segment involvement score >4 · interaction analysis | 0.89 (0.84–0.95) | P < 0.001 | |
| MACE per 10% increase in statin use, by CAD phenotype (interaction analysis, total population) — Any CAD · interaction analysis | 0.95 (0.85–1.07) | P = 0.411 | |
| 0.512Adjusted hazard ratio (log scale) |
Original publication
Interaction Between Statin Use, Coronary Artery Disease Phenotypes, on Computed Tomography Angiography, and Cardiovascular Outcomes. JACC Cardiovasc Imaging. Published 5 August 2025. doi:10.
Summarised from the published abstract; every number is checked against it