Effects of Statin for Elderly Patients With Atherosclerotic Cardiovascular Disease

Established Atherosclerotic Cardiovascular Disease (ASCVD)

A. Coronary artery disease meeting at least one of the following criteria:

• A history of coronary recanalization in multivessel coronary artery disease, evidenced by any of the following:

• Percutaneous coronary intervention (PCI) of one or more vessels, including branching arteries
• PCI or coronary artery bypass grafting (CABG) for >50% residual stenosis in separate vessels that have not undergone recanalization
• multivessel CABG at least 5 years prior to screening
• Significant coronary without prior revascularization, evidenced by >70% stenosis in at least one coronary artery, >50% stenosis in two or more coronary arteries, or >50% stenosis in the left main coronary artery arterial disease
• Known coronary calcium score > 100 in subjects who did not undergo coronary recanalization prior to randomization

B. Cerebrovascular Disease meeting at least one of the following criteria:

• Previous transient ischemic attack with carotid artery stenosis in 50%
• 70% internal or external carotid artery stenosis or >50% stenosis of two or more
• Past history of recanalization of internal or external carotid artery

C. Peripheral arterial disease meeting at least one of the following criteria:

• > 50% stenosis in the arteries of the extremities
• History of abdominal aortic treatment (percutaneous or surgical) for atherosclerotic disease
• Ankle Brachial Index (ABI) ≤ 0.90

Inclusion criteria

(must satisfy all of the following selection criteria) :

• Those who are 70 years of age or older as of the date of consent
• Established arteriosclerotic cardiovascular disease (coronary artery disease, cerebrovascular disease, or peripheral vascular disease)
• Subjects who have consented to the study plan and follow-up observation by the patient or representative, and who consented in advance in writing to the clinical subject consent approved by the research deliberation committee/ethics committee of the research institution

Exclusion criteria

• Take statins or ezetimibe within the last 4 weeks
• In case of end-stage kidney disease (eGFR<30 ml/min/1.73m2)
• Heart surgery or major surgery is planned within the next 6 months
• Patients with chronic diseases such as severe lung disease, stroke, etc.
• Patients with chronic inflammatory diseases who require oral, intravenous, or intra-articular steroid treatment (Ointments, inhalants, or intranasal steroids are allowed)
• If you have been diagnosed with cancer within the past 1 year or are currently receiving chemotherapy
• In the case of clinically significant abnormal findings that may infringe on the safety of the study by the investigator's judgment confirmed in a screening visit, physical examination, blood test, or electrocardiogram
• Liver disease, bile duct obstruction, or liver enzyme level (ALT/AST) is more than 3 times normal
• If you have a disease whose life expectancy is less than 1 year
• If you do not want or cannot comply with the procedure described in the research proposal