Supplementary MaterialsDataSheet_1. [HR]: 1.522; 95% confidence interval [CI]: 1.035C1.061; P = 0.0022) or moderate exposure (HR: 2.054; 95% CI: 1.348C3.130; P = 0.0008). This association was also found in ATs five metabolites (all P 0.01). In patients with RST treatment, moderate RST concentration (0.53C4.29 ng/ml) low concentration had a significantly lower risk of MACE and re-ischemia events. (HR: 0.532, 95% CI: 0.347C0.815, P = 0.0061 and HR: 0.505, 95% CI: 0.310C0.823, P = 0.0061, respectively). A higher plasma exposure of AT and metabolites LY2109761 pontent inhibitor has a significantly higher risk of death, and moderate RST exposure has a significantly lower risk of MACE and re-ischemia events in Chinese patients with CAD. The harms of high plasma exposure should be considered when prescribing statins to patients because it may be a risk factor for having poor prognosis in patients with CAD. placebo for all-cause mortality were similar in trials of low-, moderate-, and high-intensity statins (Chou et al., 2016). An additional randomized trial even revealed that high-dose statin pretreatment before percutaneous coronary intervention did not reduce MACEs compared with low-dose statin pretreatment (Kim et al., 2010). Moreover, no significant difference was found in MACE between patients with high-dose therapy and those with mid-dose therapy after coronary artery bypass graft surgery (Kulik et al., 2019). In addition, high-dose statin therapy may be connected with elevated dangers of severe kidney damage, myopathy, gastrointestinal hemorrhage, and diabetes (Group et al., 2008; Ridker et al., 2008; Dormuth et al., 2013; Martinez et al., 2019), raising the chance of cardiovascular events thereby. Considering that essential evidence spaces persist, recommendations had been varied among suggestions (Rock et al., 2014; Catapano et al., 2016; Power et al., 2016). For instance, the USPSTF guide (Power et al., 2016) recommends to start low- to moderate-dose statin treatment for adults aged 40C75 years who’ve no background of coronary disease (CVD), possess a number of CVD risk elements, and have a calculated 10-12 months CVD event risk of 10% or greater. In the mean time, the American College of Cardiology/American Heart Association guideline (Stone et al., 2014) recommends moderate- to high-dose statins for most asymptomatic adults aged 40C75 years without CVD history and who have a low-density lipoprotein cholesterol (LDL-C) concentration of 190 mg/dl or greater, diabetes, or an estimated 10-12 months CVD event risk of 7.5% or greater. In the absence of obvious consensus on high-intensity statin treatment, adopting high-dose statins for Asian patients should be of a greater concern, given that Asians can tolerate LY2109761 pontent inhibitor a higher-plasma statin concentration for a given dose compared with Caucasians (Lee et al., 2005; Liao, 2007). Considering that the therapeutic response at a given dose is highly variable between individuals (Pedro-Botet et al., 2001), using plasma concentration to predict therapeutic effect and further applying stratified concentrations (low, moderate, and high concentrations) to evaluate the risk of MACEs among patients should be more accurate than dosage. Therefore, in this study, we quantitatively analyzed the plasma exposure of two widely prescribed statins, namely, atorvastatin (AT) and rosuvastatin (RST), and their metabolites. Then, we assessed the impact of high-statin concentrations around the occurrence of MACE, re-ischemia events, and death in 2,448 Chinese patients with CAD. Methods Ethics Statement The present study was approved by the Medical Ethical Review Committee of Guangdong General Hospital and conducted according to the Declaration of Helsinki. Written Informed consent was obtained from all individual participants included in the study. Study Design and Patients We conducted a prospective two-stage study to evaluate the result of two statins on MACE, re-ischemia occasions, and loss of life separately. All sufferers had been sequentially prospectively signed up for Guangdong General Medical center between January 2010 and Dec 2013 based on the same inclusion and exclusion requirements. Baseline details, including demographics, health background, biochemical measurements, and medicine was extracted from the hospital details database. LY2109761 pontent inhibitor Cardiac Medical Rabbit Polyclonal to CLCNKA procedures (SYNTAX) score predicated on the outcomes of coronary angiography was computed by two experienced interventional cardiologists.