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ABSTRACT: Background
The available data are not sufficient to understand the clinical impact of statin intensity in elderly patients who undergo percutaneous coronary intervention (PCI) due to acute myocardial infarction (AMI).Methods
Using the COREA-AMI registry, we sought to compare the clinical impact of high- versus low-to-moderate-intensity statin in younger (<75 years old) and elderly (≥75 years old) patients. Of 10,719 patients, we included 8,096 patients treated with drug-eluting stents. All patients were classified into high-intensity versus low-to-moderate-intensity statin group according to statin type and dose at discharge. The primary end point was target-vessel failure (TVF), a composite of cardiovascular death, target-vessel MI, or target-lesion revascularization (TLR) from 1 month to 12 months after index PCI.Results
In younger patients, high-intensity statin showed the better clinical outcomes than low-to-moderate-intensity statin (TVF: 79 [5.4%] vs. 329 [6.8%], adjusted hazard ratio [aHR] 0.76; 95% confidence interval [CI] 0.59-0.99; P = 0.038). However, in elderly patients, the incidence rates of the adverse clinical outcomes were similar between two statin-intensity groups (TVF: 38 [11.4%] vs. 131 [10.6%], aHR 1.1; 95% CI 0.76-1.59; P = 0.63).Conclusions
In this AMI cohort underwent PCI, high-intensity statin showed the better 1-year clinical outcomes than low-to-moderate-intensity statin in younger patients. Meanwhile, the incidence rates of adverse clinical events between high- and low-to-moderate-intensity statin were not statistically different in elderly patients. Further randomized study with large elderly population is warranted.
SUBMITTER: Lee K
PROVIDER: S-EPMC9200343 | biostudies-literature | 2022
REPOSITORIES: biostudies-literature
Lee Kyusup K Lee Myunhee M Kim Dae-Won DW Kim Jinseob J Lim Sungmin S Choo Eun Ho EH Kim Chan Joon CJ Park Chul Soo CS Kim Hee Yeol HY Yoo Ki-Dong KD Jeon Doo Soo DS Chang Kiyuk K Youn Ho Joong HJ Chung Wook-Sung WS Kim Min Chul MC Jeong Myung Ho MH Ahn Youngkeun Y Kwon Jongbum J Park Mahn-Won MW
PloS one 20220615 6
<h4>Background</h4>The available data are not sufficient to understand the clinical impact of statin intensity in elderly patients who undergo percutaneous coronary intervention (PCI) due to acute myocardial infarction (AMI).<h4>Methods</h4>Using the COREA-AMI registry, we sought to compare the clinical impact of high- versus low-to-moderate-intensity statin in younger (<75 years old) and elderly (≥75 years old) patients. Of 10,719 patients, we included 8,096 patients treated with drug-eluting s ...[more]