Impact of high-dose statin on cardiovascular outcomes in real-world patients with ST-elevation acute myocardial infarction.
Aged
Coronary Angiography
Dose-Response Relationship, Drug
Electrocardiography
Female
Follow-Up Studies
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors
/ administration & dosage
Male
Middle Aged
Percutaneous Coronary Intervention
/ methods
Propensity Score
Prospective Studies
ST Elevation Myocardial Infarction
/ diagnosis
Treatment Outcome
Coronary revascularization
High-dose statin
Japanese
Myocardial infarction
STEMI
Journal
Heart and vessels
ISSN: 1615-2573
Titre abrégé: Heart Vessels
Pays: Japan
ID NLM: 8511258
Informations de publication
Date de publication:
Mar 2021
Mar 2021
Historique:
received:
11
06
2020
accepted:
28
08
2020
pubmed:
4
9
2020
medline:
15
7
2021
entrez:
4
9
2020
Statut:
ppublish
Résumé
Little is known about the impact of a high-dose statin on cardiovascular outcomes after ST-elevation acute myocardial infarction (STEMI) in real-world Japanese patients. Between July 2011 and June 2017, 1110 consecutive STEMI patients underwent primary percutaneous coronary intervention at our hospital and were discharged. A high-dose statin was administered in 117 patients (10.5%) and non-high-dose statin was administered in 947 patients (85.3%). The low-density lipoprotein cholesterol level was significantly higher in the high-dose statin group at admission (129.8 ± 44.9 vs. 110.4 ± 32.7, p < 0.0001), but the levels were not significantly different at follow-up (86.7 ± 25.7 vs. 85.0 ± 25.0, p = 0.52). The cumulative 2-year incidence of a composite of cardiac death, myocardial infarction, ischemic stroke, and any unplanned coronary revascularization was significantly lower in the high-dose statin group (6.2% vs. 16.9%, log-rank p = 0.004). Propensity score matched analysis indicated similar results. Among the types of coronary revascularization, a high-dose statin was significantly correlated with a lower rate of de novo lesion revascularization (hazard ratio 0.31; 95% confidence interval 0.08-0.83; p = 0.02). The results of our analyses indicate that administration of a high-dose statin may result in better cardiovascular outcomes after STEMI mainly by reducing the rate of revascularization for de novo lesions regardless of the achieved low-density lipoprotein cholesterol level in real-world patients.
Identifiants
pubmed: 32880682
doi: 10.1007/s00380-020-01696-9
pii: 10.1007/s00380-020-01696-9
doi:
Substances chimiques
Hydroxymethylglutaryl-CoA Reductase Inhibitors
0
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
297-307Références
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