Do Statins Have a Positive Impact on Patients with Coronary Microvascular Dysfunction on Long-Term Clinical Outcome? A Large Retrospective Cohort Study

Abstract

Objectives. To investigate the influence of statins on major adverse cardiovascular events (MACE) in patients with coronary microvascular dysfunction (CMVD). Participants. 23,494 patients who received coronary angiography (CAG) were included. Thrombolysis in Myocardial Infarction, Myocardial Perfusion Grading (TMPG), a useful angiographic method, was used to evaluate CMVD. Results. Using multivariate analysis, NYHA III/IV (HR, 1.44; 95% CI, 1.03-2.01; P=0.031), PCI history (HR, 3.69; 95% CI, 2.57-5.31; P<0.001), TG (HR, 1.15; 95% CI, 1.06-1.26; P=0.001), creatinine (HR, 1.00; 95% CI, 1.00-1.01; P<0.001), cTnT (HR, 0.98; 95% CI, 0.96-0.99; P<0.001), heart rate (HR, 0.98; 95% CI, 0.97-0.99; P=0.001), β-blocker (HR, 0.68; 95% CI, 0.51-0.91; P=0.008), aspirin (HR, 0.38; 95% CI, 0.24-0.61; P<0.001), and statins (HR, 0.33; 95% CI, 0.19-0.60; P<0.001) significantly correlated with reduced MACE in CMVD patients. In subgroups analysis, statins decreased MACE overall (HR, 0.33; 95% CI, 0.19-0.59; P<0.001) and in CMVD patients with smoking history (HR, 0.64; 95% CI, 0.43-0.93; P=0.014), diabetes (HR,0.27; 95% CI,0.12-0.61; P=0.002), hypertension (HR, 0.10; 95% CI, 0.03-0.36; P=0.001), and hypertension and diabetes (HR, 0.09; 95% CI, 0.014-0.53; P=0.008). Conclusion. Statins could reduce MACE in patients with CMVD.

Shexiang Tongxin Dropping Pills Promote Macrophage Polarization-Induced Angiogenesis Against Coronary Microvascular Dysfunction via PI3K/Akt/mTORC1 Pathway

“…In the clinic, the treatment for CMD mainly focuses on drug treatment, including antiplatelet drugs, antiarrhythmic drugs, antiangina drugs, and calcium antagonists ( Ong et al, 2016 ). However, increasing the risk of bleeding and other adverse reactions might exist ( Luo et al, 2019 ). Shexiang Tongxin dropping pills (STDPs) were approved for marketing by the National Medical Products Administration in 2008, which consist of seven components: Centaurea moschus Hablitz, Ginseng quinquefolium (L.) Alph.Wood, Bufonis Venenum , Salvia absconditiflora Greuter and Burdet, Bovis Calculus Artifactus , Fel Ursi , and Dryobalanops aromatica C.F.Gaertn ( Chen et al, 2015 ; Lin et al, 2017 ).…”

Effect of Statins on Major Adverse Cardiovascular Events in Patients with Coronary Artery Spasm: A Meta-Analysis of the Asia Region

“…Of the 10 studies included in the present meta-analysis, the degree of overlap is unknown. A study consisted of 925 patients showed that statin treatment was associated with decreased MACE in CMVD patients over a long-term period (more than 10 years) [ 34 ].…”

Global trends and frontiers in research on coronary microvascular dysfunction: a bibliometric analysis from 2002 to 2022

“…Therefore, CMD may serve as a crucial therapeutic target. Current studies have found that the coronary flow reserve can be enhanced by drugs targeting the renin-angiotensin-aldosterone system, statins, calcium channel blockers, and ranolazine to minimize MACEs [81][82][83][84][85][86]. Some traditional Chinese medicines have also been used to treat CMD, including Shenmai injection and Shexiang Tongxin dropping pills, which may improve coronary microvascular function, endothelial function, and microvascular structure abnormalities by reducing oxidative stress, inflammatory response, and apoptosis [87,88].…”