Abstract
Objectives: We investigated whether statin therapy could be beneficial in patients with acute myocardial infarction (AMI) who have baseline low-density lipoprotein cholesterol (LDL-C) levels below 70 mg/dl. Background: Intensive lipid-lowering therapy with a target LDL-C value <70 mg/dl is recommended in patients with very high cardiovascular risk. However, whether to use statin therapy in patients with baseline LDL-C levels below 70 mg/dl is controversial. Methods: We analyzed 1,054 patients with AMI who had baseline LDL-C levels below 70 mg/dl and survived at discharge from the Korean Acute MI Registry between November 2005 and December 2007. They were divided into 2 groups according to the prescribing of statins at discharge (statin group n = 607; nonstatin group n = 447). The primary endpoint was the composite of 1-year major adverse cardiac events, including death, recurrent MI, target vessel revascularization, and coronary artery bypass grafting. Results: Statin therapy significantly reduced the risk of the composite primary endpoint (adjusted hazard ratio [HR]: 0.56; 95% confidence interval [CI]: 0.34 to 0.89; p = 0.015). Statin therapy reduced the risk of cardiac death (HR: 0.47; 95% CI: 0.23 to 0.93; p = 0.031) and coronary revascularization (HR: 0.45, 95% CI: 0.24 to 0.85; p = 0.013). However, there were no differences in the risk of the composite of all-cause death, recurrent MI, and repeated percutaneous coronary intervention rate. Conclusions: Statin therapy in patients with AMI with LDL-C levels below 70 mg/dl was associated with improved clinical outcome.
Original language | English |
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Pages (from-to) | 1664-1671 |
Number of pages | 8 |
Journal | Journal of the American College of Cardiology |
Volume | 58 |
Issue number | 16 |
DOIs | |
Publication status | Published - 2011 Oct 11 |
Bibliographical note
Funding Information:This study was supported by a grant of the Korea Healthcare technology R&D project, Ministry for Health, Welfare & Family Affairs , Republic of Korea ( A084869 ). Dr. Chae has received research grants from GlaxoSmithKline , MSD , Novartis , Pfizer , and Sanofi-Aventis . All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Keywords
- low-density lipoprotein cholesterol
- myocardial infarction
- statin
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine