Coronary disease & ACSCohort study
Lipid-Lowering Medication and Outcomes After Anatomical and Functional Imaging in Suspected Coronary Artery Disease
- Cohort study
- consecutive patients
Authors' conclusion
The CAD phenotype defined by anatomical and functional imaging guides the use of LLM. The presence of myocardial ischemia and anatomical obstructive coronary lesions were associated with a long-term outcome benefit from LLM.
Study context
- Population
- Patients with suspected obstructive coronary artery disease (CAD) undergoing coronary computed tomography angiography (CTA), with PET ischemia testing where obstructive CAD was not ruled out41% men
- Participants
- 1,973 patients
- Exposure
- Lipid-lowering medication (LLM) use vs no LLM use, by CAD phenotype on CTA and PET
- Outcome
- Composite of:
- Death
- MI
- Unstable angina pectoris
- Follow-up
- Median 6.7 years
Main finding
As reported in the abstract
Myocardial ischemia: lower rate with LLM
6.1% vs 2.8%; P = 0.032
Obstructive CAD without myocardial ischemia: lower rate with LLM
2.9% vs 1.4%; P = 0.004
Nonobstructive CAD: no association
1.5% vs 1.4%; P = 0.89
No CAD: no association
0.3% vs 0.3%; P = 0.68
Observational data: associations, not effects.
Further findings
LLM use after imaging, by CAD phenotype
- No CAD
- 24%
- Nonobstructive CAD
- 51%
- Obstructive CAD on CTA without myocardial ischemia
- 72%
- Myocardial ischemia
- 91%
LLM use for 2 years, myocardial ischemia
- Patients with myocardial ischemia using LLM for 2 years (use decreased during follow-up)
- 77%
Original publication
Summarised from the published abstract; every number is checked against it