{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,30]],"date-time":"2025-07-30T11:42:26Z","timestamp":1753875746030,"version":"3.41.2"},"reference-count":23,"publisher":"Oxford University Press (OUP)","issue":"7","license":[{"start":{"date-parts":[[2024,7,1]],"date-time":"2024-07-01T00:00:00Z","timestamp":1719792000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,7,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The optimal statin treatment strategy that is balanced for both efficacy and safety has not been clearly determined in older adults with coronary artery disease (CAD).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>In the post hoc analysis of the LODESTAR (low-density lipoprotein cholesterol-targeting statin therapy versus intensity-based statin therapy in patients with coronary artery disease) trial, the impact between a treat-to-target strategy versus a high-intensity statin therapy strategy was compared in older adults (aged 75\u00a0years or older). The goal of treat-to-target low-density lipoprotein cholesterol (LDL-C) level was 50\u201370\u00a0mg\/dl. The primary endpoint comprised the three-year composite of all-cause death, myocardial infarction, stroke or coronary revascularisation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Among 4,400 patients with CAD enrolled in the LODESTAR trial, 822 (18.7%) were aged 75\u00a0years or older. Poor clinical outcomes and risk factors for atherosclerosis were more frequently observed in older adults than in younger population (&amp;lt;75\u00a0years old). Among these older adults with CAD, the prescription rate of high-intensity statin was significantly lower in the treat-to-target strategy group throughout the study period (P\u2009&amp;lt;\u20090.001). The mean LDL-C level for three years was 65\u2009\u00b1\u200916\u00a0mg\/dl in the treat-to-target strategy group and 64\u2009\u00b1\u200918\u00a0mg\/dl in the high-intensity statin group (P\u2009=\u20090.34). The incidence of primary endpoint occurrence was 10.9% in the treat-to-target strategy group and 12.0% in the high-intensity statin group (hazard ratio 0.92, 95% confidence interval 0.61\u20131.38, P\u2009=\u20090.69).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>High-intensity statin therapy is theoretically more necessary in older adults because of worse clinical outcomes and greater number of risk factors for atherosclerosis. However, the primary endpoint occurrence with a treat-to-target strategy with an LDL-C goal of 50\u201370\u00a0mg\/dl was comparable to that of high-intensity statin therapy and reduced utilisation of a high-intensity statin. Taking efficacy as well as safety into account, adopting a tailored approach may be considered for this high-risk population.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial Registration<\/jats:title>\n                  <jats:p>ClinicalTrials.gov, NCT02579499.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ageing\/afae132","type":"journal-article","created":{"date-parts":[[2024,7,5]],"date-time":"2024-07-05T01:08:49Z","timestamp":1720141729000},"source":"Crossref","is-referenced-by-count":1,"title":["Treat-to-target or high-intensity statin treatment in older adults with coronary artery disease: a post hoc analysis of the LODESTAR trial"],"prefix":"10.1093","volume":"53","author":[{"given":"Seung-Jun","family":"Lee","sequence":"first","affiliation":[{"name":"Severance Hospital, Yonsei University College of Medicine , 50-1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, 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Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Junghan","family":"Yoon","sequence":"additional","affiliation":[{"name":"Wonju Severance Christian Hospital , Ilsan-ro, 26426, Wonju, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yangsoo","family":"Jang","sequence":"additional","affiliation":[{"name":"CHA University College of Medicine , Yatap-ro, Bundang-gu, 13497, Seongnam, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Myeong-Ki","family":"Hong","sequence":"additional","affiliation":[{"name":"Severance Hospital, Yonsei University College of Medicine , 50-1 Yonsei-ro, Seodaemun-gu, 03722, Seoul, Korea"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"name":"for the LODESTAR investigators","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"H 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