Lipid Goal Achievement With Statins Among Statin-Naïve Indian Patients Undergoing Percutaneous Coronary Intervention

Background The effectiveness of current statin therapy in achieving lipid targets in Indian patients remains uncertain. This observational study aimed to evaluate lipid goal attainment at 1 and 6 months with atorvastatin and rosuvastatin in statin-naïve South Indian patients undergoing percutaneous coronary intervention (PCI). Methods This prospective, observational, single-center study included 491 statin-naïve patients who underwent PCI between March 2021 and May 2023. Effects of statins on low-density lipoprotein cholesterol (LDL-C) reduction and lipid goal achievement were assessed at 1 and 6 months. Secondary objectives compared the individual efficacy of atorvastatin vs rosuvastatin, the impact of baseline lipids, statin switching, and the association between lipid goal achievement and major adverse cardiovascular events. Results Among 491 patients (mean age, 58.7 years), 437 (89%) presented with acute coronary syndrome. Atorvastatin was prescribed to 327 (66%) and rosuvastatin to 164 (34%). Baseline LDL-C was lower in the rosuvastatin group (122.7 ± 46.2 vs 138.2 ± 48.5 mg/dL; P = .001). At 1 month, 41% achieved American Heart Association/American College of Cardiology lipid goals (47.6% with rosuvastatin vs 37.1% with atorvastatin; P = .041). Atorvastatin to rosuvastatin switching was done in 113 (34.6%) patients. By 6 months, 42.5% achieved goals. Rosuvastatin showed better LDL-C goal attainment (62.8% vs 38.2%; P < .001). Rosuvastatin switching modestly improved outcomes ( P ≤ .036). Conclusions Only 41.1% and 42.5% of statin-naïve Indian patients undergoing PCI achieved lipid goals on statins at 1 and 6 months, suggesting a need for more intensive lipid-lowering strategies post-PCI. Rosuvastatin was marginally more efficacious than atorvastatin.