Korean Circulation Journal

The Korean Society of Cardiology (대한심장학회)
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Statins and Clinical Outcomes in Patients With Low to Moderate Risk but With Non-obstructive Carotid Plaques: The SCOPE-CP Study

  • Minjae Yoon (Division of Cardiology, Department of Internal Medicine, Seoul National University Bundang Hospital) ;
  • Chan Joo Lee (Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Sungha Park (Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine) ;
  • Sang-Hak Lee (Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine)
  • Received : 2022.05.20
  • Accepted : 2022.09.20
  • Published : 2022.12.01
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Abstract

Background and Objectives: Some individuals exhibit discrepancies between risk classifications assessed using clinical factors and those obtained by vascular imaging. We aimed to evaluate whether statins provide clinical outcome benefits in patients classified as having low to moderate cardiovascular risk but with carotid plaque. Methods: This was a retrospective propensity score matching study. A total of 12,158 consecutive patients undergoing carotid ultrasound between January 2012 to February 2020 were screened. Individuals with low to moderate cardiovascular risk who were not currently recommended for statin therapy but had carotid plaques were included. Among 1,611 enrolled individuals, 806 (statin group: 403, control group: 403) were analyzed. The primary outcomes were major adverse cardiovascular and cerebrovascular events (MACCEs: cardiovascular death, myocardial infarction, coronary revascularization, and ischemic stroke or transient ischemic attack) and all-cause mortality. Results: During the median follow-up of 6.0 years, the incidence of MACCEs did not differ between the groups (6.1 and 5.7/1,000 person-years in the control and statin groups, respectively; adjusted hazard ratio [HR], 0.95; p=0.90). The incidence of all-cause mortality did not differ (3.9 and 3.9/1,000 person-years, respectively; adjusted HR, 1.02; p=0.97). Kaplan-Meier curves revealed similar rates of MACCEs (log-rank p=0.72) and all-cause mortality (log-rank p=0.99) in the 2 groups. Age and smoking were independent predictors of MACCEs. Subgroups exhibited no differences in clinical outcomes with statin use. Conclusions: Benefit of statin therapy was likely to be limited in low to moderate risk patients with carotid plaques. These results could guide physicians in clinical decision-making regarding cardiovascular prevention.

Keywords

Acknowledgement

This work was supported by the National Research Foundation of Korea, funded by the Korean government (grant No. 2022R1A2C1004946). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.

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