Prevention & lipidsCohort study
Interaction Between Statin Use, Coronary Artery Disease Phenotypes, on Computed Tomography Angiography, and Cardiovascular Outcomes
- Retrospective cohort study
- single-centre
- consecutive patients
- interaction analysis
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
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:10.1016/j.jcmg.2025.05.018
Summarised from the published abstract; every number is checked against it