Dataset Information

Benefit of Early Statin Initiation within 48 Hours after Admission in Statin-Naive Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention.

ABSTRACT:

Background and objectives

Although current guidelines recommend early initiation of statin in patients with acute myocardial infarction (AMI), there is no consensus for optimal timing of statin initiation.

Methods

A total of 3,921 statin-naïve patients undergoing percutaneous coronary intervention were analyzed, and divided into 3 groups according to statin initiation time: group 1 (statin initiation <24 hours after admission), group 2 (24-48 hours) and group 3 (≥48 hours). We also made 3 stratified models to reduce bias: model 1 (<24 hours vs. ≥24 hours), model 2 (<48 hours vs. ≥48 hours) and model 3 (<24 hours vs. 24-48 hours). The endpoint was major adverse cardiac events (MACE; composite of cardiac death, myocardial infarction and target-vessel revascularization) during median 3.8 years.

Results

During follow-up, incidence of MACE was lower in early statin group in both model 1 (14.3% vs. 18.4%, hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.66-0.91; p=0.002) and model 2 (14.6% vs. 19.7%, HR, 0.81; 95% CI, 0.67-0.97; p=0.022). After propensity-score matching, results remained unaltered. Statin initiation <24 hours reduced MACE compared to statin initiation ≥24 hours in model 1. Statin initiation <48 hours also reduced MACE compared to statin initiation later in model 2. However, there was no difference in incidence of MACE between statin initiation <24 hours and 24-48 hours) in model 3.

Conclusions

Early statin therapy within 48 hours after admission in statin-naïve patients with AMI reduced long-term clinical outcomes compared with statin initiation later.

Trial registration

ClinicalTrials.gov Identifier: NCT02385682.

SUBMITTER: Kim MC

PROVIDER: S-EPMC6511534 | biostudies-literature | 2019 May

REPOSITORIES: biostudies-literature

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Publications

Benefit of Early Statin Initiation within 48 Hours after Admission in Statin-Naïve Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention.

Kim Min Chul MC Ahn Youngkeun Y Cho Jae Yeong JY Lee Ki Hong KH Sim Doo Sun DS Yoon Nam Sik NS Yoon Hyun Ju HJ Kim Kye Hun KH Hong Young Joon YJ Park Hyung Wook HW Kim Ju Han JH Jeong Myung Ho MH Cho Jeong Gwan JG Park Jong Chun JC Chang Kiyuk K Seung Ki Bae KB

Korean circulation journal 20190212 5

<h4>Background and objectives</h4>Although current guidelines recommend early initiation of statin in patients with acute myocardial infarction (AMI), there is no consensus for optimal timing of statin initiation.<h4>Methods</h4>A total of 3,921 statin-naïve patients undergoing percutaneous coronary intervention were analyzed, and divided into 3 groups according to statin initiation time: group 1 (statin initiation <24 hours after admission), group 2 (24-48 hours) and group 3 (≥48 hours). We als ...[more]

PMID: 30808084

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