Relationship between LDL-C Reduction after Coronary Revascularization and Prevention of Recurrence of Cardiovascular Events

Authors

  • Tatsuhiro Nishiwaki Toho University
  • Mitsutoshi Satoh
  • Daisuke Kishi
  • Fumihiko Yoshie
  • Keiko Fukuda
  • Chikao Ibuki
  • Yoshihiko Seino

DOI:

https://doi.org/10.18433/J3HG6Q

Abstract

Purpose. The purpose of our study was to optimize lipid-lowering therapy in patients undergoing coronary revascularization and to determine whether the percentage change in low-density lipoprotein-cholesterol (LDL-C) level in the 3 months after coronary revascularization could be used as a predictor of the time to recurrence of coronary artery disease (CAD). Methods. Biochemical values of patients undergoing lipid-lowering therapy after receiving coronary revascularization at the Nippon Medical School Chiba Hokusoh Hospital, Japan, were retrospectively investigated. Recurrence of a cardiovascular event (CVE) was defined by death, myocardial infarction, or angina caused by coronary revascularization more than 3 months after the first event. Results. Of 171 patients under secondary preventive care who had at least one recurrence of a CVE, 75 showed evidence of objective stenotic lesions on coronary angiography. Among these 75 patients, exclusion of those in whom coronary revascularization had not been performed at disease onset, balloon dilatation had been used, serum lipid levels had not been measured, or coronary revascularization had been applied to restenosis left 44 patients suitable for inclusion in the study group. Although the mean value of high density lipoprotein-cholesterol did not change in the 3 months after coronary revascularization, that of (LDL-C) significantly decreased. A significant positive correlation was identified between % decrease in LDL-C and number of days to CVE recurrence. The average LDL-C value (102.8±21.7 mg/dL) in the group of patients with no recurrence within 5 years was significantly lower than that (135.3±46.1 mg/dL) in the recurrence group (P = 0.0088). The % of patients achieving the LDL-C target level (non-recurrence group vs. recurrence group: 50.0% vs. 16.7%; P = 0.032) and the % decrease in LDL-C (31.0%±12.6% vs. 9.6±21.0%, P = 0.0012) were significantly greater in the non-recurrence group than in the recurrence group. Conclusion. From our present study, a decrease in LDL-C 3 months after revascularization surgery reduces the rate of CVE relapse. The % LDL-C decrease could serve as a useful predictor of CVE recurrence, in addition to LDL-C values and achievement of the LDL-C target level.

Downloads

Download data is not yet available.

Author Biographies

Tatsuhiro Nishiwaki, Toho University

Department of Toxicology and Pharmacology, Faculty of Pharmaceutical, Sciences

Mitsutoshi Satoh

Department of Toxicology and Pharmacology, Faculty of Pharmaceutical, Sciences

Downloads

Published

2010-07-29

How to Cite

Nishiwaki, T., Satoh, M., Kishi, D., Yoshie, F., Fukuda, K., Ibuki, C., & Seino, Y. (2010). Relationship between LDL-C Reduction after Coronary Revascularization and Prevention of Recurrence of Cardiovascular Events. Journal of Pharmacy & Pharmaceutical Sciences, 13(2), 254–262. https://doi.org/10.18433/J3HG6Q

Issue

Section

Pharmaceutical Sciences; Review Articles