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Efficacy and Safety of High-Intensity Statins in Japanese Patients After Percutaneous Coronary Intervention ― Insights From the Clinical Deep Data Accumulation System (CLIDAS<sup>®</sup>) ―
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- Matoba Tetsuya
- Department of Cardiovascular Medicine, Kyushu University Hospital
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- Katsuki Shunsuke
- Department of Cardiovascular Medicine, Kyushu University Hospital
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- Nakano Yasuhiro
- Department of Cardiovascular Medicine, Kyushu University Hospital
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- Kawahara Takuro
- Department of Cardiovascular Medicine, Kyushu University Hospital
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- Kimura Mitsukuni
- Department of Cardiovascular Medicine, Kyushu University Hospital
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- Hino Rissei
- Department of Cardiovascular Medicine, Kyushu University Hospital
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- Tabuchi Takuya
- Department of Cardiovascular Medicine, Kyushu University Hospital
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- Fukata Mitsuhiro
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital
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- Hieda Michinari
- Department of Hematology, Oncology and Cardiovascular Medicine, Kyushu University Hospital
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- Yamashita Takanori
- Medical Information Center, Kyushu University Hospital
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- Nakashima Naoki
- Department of Medical Informatics, Graduate School of Medical Sciences, Kyushu University
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- Kohro Takahide
- Department of Medical Informatics, Jichi Medical University Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University
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- Kabutoya Tomoyuki
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University
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- Oba Yusuke
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University
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- Kario Kazuomi
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University
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- Imai Yasushi
- Department of Clinical Pharmacology, Jichi Medical University
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- Fujita Hideo
- Division of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center
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- Akashi Naoyuki
- Division of Cardiovascular Medicine, Jichi Medical University Saitama Medical Center
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- Kiyosue Arihiro
- Department of Cardiovascular Medicine, The University of Tokyo Cardiology, Moriyama Memorial Hospital
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- Mizuno Yoshiko
- Department of Cardiovascular Medicine, The University of Tokyo Development Bank of Japan Inc.
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- Kodera Satoshi
- Department of Cardiovascular Medicine, The University of Tokyo
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- Nakayama Masaharu
- Department of Medical Informatics, Tohoku University Graduate School of Medicine
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- Nochioka Kotaro
- Division of Cardiovascular Medicine, Tohoku University Hospital
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- Miyamoto Yoshihiro
- Open Innovation Center, National Cerebral and Cardiovascular Center,
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- Iwai Takamasa
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Center,
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- Tsujita Kenichi
- Department of Cardiovascular Medicine, Kumamoto University
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- Nakamura Taishi
- Department of Cardiovascular Medicine, Kumamoto University Department of Medical Information Science, Kumamoto University
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- Ishii Masanobu
- Department of Cardiovascular Medicine, Kumamoto University Department of Medical Information Science, Kumamoto University
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- Sato Hisahiko
- Precision Inc.
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- Matoba Yuri
- Precision Inc.
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- Nagai Ryozo
- Jichi Medical University
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Description
<p>Background: Lipid-lowering therapy with high-intensity statins has not been widely implemented in Japan for patients with coronary artery disease who undergo percutaneous coronary intervention (PCI). We examined the efficacy and safety of high-intensity statin therapy in a real-world setting.</p><p>Methods and Results: We used the Clinical Deep Data Accumulation System (CLIDAS) to accumulate multimodal data from the electronic medical records of 7 cardiovascular centers. We analyzed 9,690 patients who underwent PCI between 2013 and 2019 and completed a median 2.5-year follow-up (CLIDAS-PCI database). The risk of developing major adverse cardiac and cerebrovascular events (MACCE) was significantly greater in patients with acute (ACS) than chronic (CCS) coronary syndrome. High-intensity statins were prescribed to 49% of ACS patients and 33% of CCS patients within the first 30 days after the index PCI. After propensity score matching, MACCE event rates were similar between the high- and moderate-intensity statin groups. Importantly, among ACS patients, Cox proportional hazard analysis revealed that the rate of myocardial infarction was lower (adjusted hazard ratio [aHR] 0.65; 95% confidence interval [CI] 0.44–0.97) and the rate of stroke was greater (aHR 1.71; 95% CI 1.12–2.62) in the high-intensity statin group, driven mostly by intracranial hemorrhage.</p><p>Conclusions: The CLIDAS-PCI database provides real-world evidence for the efficacy and safety of high-intensity statins in Japanese ACS patients who have undergone PCI.</p>
Journal
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- Circulation Journal
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Circulation Journal advpub (0), 2025-06-19
The Japanese Circulation Society