Department of Cardiology, Tokyo Women's Medical University.
Department of Cardiology, Tokyo Women's Medical University Yachiyo Medical Center.
Circ J. 2024 Oct 25;88(11):1819-1824. doi: 10.1253/circj.CJ-24-0536. Epub 2024 Sep 11.
This study investigated whether intensive lipid-lowering therapy with pitavastatin and ezetimibe lowers the incidence of heart failure (HF) events in patients with acute coronary syndrome (ACS).
In the HIJ-PROPER study, 1,734 patients with ACS were randomly assigned to either pitavastatin plus ezetimibe therapy (n=864) or pitavastatin monotherapy (n=857). We examined the incidence of HF between these 2 groups over a 3.9-year period after ACS. The primary endpoint of the study was hospitalization for HF. The mean low-density lipoprotein cholesterol levels during the follow-up period were 65.1 mg/dL in the pitavastatin plus ezetimibe group and 84.6 mg/dL in the pitavastatin monotherapy group. The incidence of HF hospitalization was significantly lower in the pitavastatin plus ezetimibe group than in the pitavastatin monotherapy group (19 [2.2%] vs. 40 [4.7%] patients; hazard ratio 0.47, 95% confidence interval 0.27-0.81; P<0.005). This trend was consistent after multivariable analysis using multiple models.
Intensive lipid-lowering therapy with pitavastatin and ezetimibe is associated with a lower incidence of hospitalization for HF in patients with ACS.
本研究旨在探讨匹伐他汀联合依折麦布强化降脂治疗是否降低急性冠脉综合征（ACS）患者心力衰竭（HF）事件的发生率。
在 HIJ-PROPER 研究中，1734 例 ACS 患者被随机分为匹伐他汀联合依折麦布治疗组（n=864）和匹伐他汀单药治疗组（n=857）。我们在 ACS 后 3.9 年的时间内观察了这两组之间 HF 的发生率。研究的主要终点是 HF 住院。在随访期间，匹伐他汀联合依折麦布组的平均低密度脂蛋白胆固醇水平为 65.1mg/dL，匹伐他汀单药组为 84.6mg/dL。匹伐他汀联合依折麦布组的 HF 住院发生率明显低于匹伐他汀单药组（19 [2.2%] 例 vs. 40 [4.7%] 例；风险比 0.47，95%置信区间 0.27-0.81；P<0.005）。在使用多种模型的多变量分析后，这一趋势仍然一致。
匹伐他汀联合依折麦布强化降脂治疗与 ACS 患者 HF 住院发生率降低相关。
