Impact of high-dose statin on cardiovascular outcomes in real-world patients with ST-elevation acute myocardial infarction.

Autor: Shimada, Takenobu, Osakada, Kohei, Okabe, Koya, Shima, Yuki, Eguchi, Haruki, Habara, Seiji, Tada, Takeshi, Taguchi, Yuya, Ikuta, Akihiro, Takamatsu, Makoto, Murai, Ryosuke, Miura, Katsuya, Ohya, Masanobu, Amano, Hidewo, Kubo, Shunsuke, Tanaka, Hiroyuki, Maruo, Takeshi, Fuku, Yasushi, Katoh, Harumi, Goto, Tsuyoshi
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Zdroj: Heart & Vessels; Mar2021, Vol. 36 Issue 3, p297-307, 11p
Abstrakt: 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. [ABSTRACT FROM AUTHOR]
Databáze: Complementary Index