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Benefits of Statin Therapy in Patients With Acute Myocardial Infarction With Serum Low-Density Lipoprotein Cholesterol ≤ 50 mg/dl.

Abstract Previous trials have found that statin therapy reduces low-density lipoprotein cholesterol (LDL-C) level and the risk of cardiovascular events. However, the benefit of statin therapy in patients with baseline LDL-C levels ≤ 50 mg/dl is less clear. Therefore, the aim of this study was to assess whether patients with acute myocardial infarction (AMI) who have baseline LDL-C levels ≤ 50 mg/dl would benefit from statin therapy in real-world clinical practice. We analyzed the clinical data of 1,048 patients (67.3 ± 12.6 years, 69.6% men) with AMI, who had baseline LDL-C levels ≤ 50 mg/dl from the Korean Acute Myocardial Infarction Registry data between November 2005 and May 2014. They were divided into 2 groups based on whether they were prescribed statins or not at discharge (statin and nonstatin group, n = 738 and 310, respectively). The primary end point was the major adverse cardiac event (MACE), defined as the composite of all-cause mortality, recurrent myocardial infarction, and repeated percutaneous coronary intervention or coronary artery bypass grafting. MACE occurred in 9.2% of the statin group versus 19.6% in the nonstatin group during the 12-month follow-up. Statin therapy significantly reduced the risk of MACE (hazard ratio [HR] 0.60, 95% CI 0.39 to 0.94, p = 0.025) and coronary artery bypass grafting (HR 0.27, 95% CI 0.08 to 0.96, p = 0.043). There was a trend of reduced cardiac death in the statin group compared with the nonstatin group (HR 0.52, 95% CI 0.26 to 1.02, p = 0.059). Statin therapy for patients with AMI with LDL-C levels ≤ 50 mg/dl was associated with improved outcomes. Therefore, statin therapy is feasible and effective, even in AMI patients with extremely low levels of LDL-C.
PMID
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Authors

Mayor MeshTerms
Keywords
Journal Title the american journal of cardiology
Publication Year Start




PMID- 28532771
OWN - NLM
STAT- Publisher
DA  - 20170523
LR  - 20170523
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
DP  - 2017 Apr 27
TI  - Benefits of Statin Therapy in Patients With Acute Myocardial Infarction With
      Serum Low-Density Lipoprotein Cholesterol &lt;/= 50 mg/dl.
LID - S0002-9149(17)30691-4 [pii]
LID - 10.1016/j.amjcard.2017.04.003 [doi]
AB  - Previous trials have found that statin therapy reduces low-density lipoprotein
      cholesterol (LDL-C) level and the risk of cardiovascular events. However, the
      benefit of statin therapy in patients with baseline LDL-C levels &lt;/= 50 mg/dl is 
      less clear. Therefore, the aim of this study was to assess whether patients with 
      acute myocardial infarction (AMI) who have baseline LDL-C levels &lt;/= 50 mg/dl
      would benefit from statin therapy in real-world clinical practice. We analyzed
      the clinical data of 1,048 patients (67.3 +/- 12.6 years, 69.6% men) with AMI,
      who had baseline LDL-C levels &lt;/= 50 mg/dl from the Korean Acute Myocardial
      Infarction Registry data between November 2005 and May 2014. They were divided
      into 2 groups based on whether they were prescribed statins or not at discharge
      (statin and nonstatin group, n = 738 and 310, respectively). The primary end
      point was the major adverse cardiac event (MACE), defined as the composite of
      all-cause mortality, recurrent myocardial infarction, and repeated percutaneous
      coronary intervention or coronary artery bypass grafting. MACE occurred in 9.2%
      of the statin group versus 19.6% in the nonstatin group during the 12-month
      follow-up. Statin therapy significantly reduced the risk of MACE (hazard ratio
      [HR] 0.60, 95% CI 0.39 to 0.94, p = 0.025) and coronary artery bypass grafting
      (HR 0.27, 95% CI 0.08 to 0.96, p = 0.043). There was a trend of reduced cardiac
      death in the statin group compared with the nonstatin group (HR 0.52, 95% CI 0.26
      to 1.02, p = 0.059). Statin therapy for patients with AMI with LDL-C levels &lt;/=
      50 mg/dl was associated with improved outcomes. Therefore, statin therapy is
      feasible and effective, even in AMI patients with extremely low levels of LDL-C.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Piao, Zhe Hao
AU  - Piao ZH
AD  - The Second Hospital of Jilin University, Changchun, China; Chonnam National
      University Hospital, Gwangju, Republic of Korea.
FAU - Jin, Li
AU  - Jin L
AD  - The Second Hospital of Jilin University, Changchun, China; Jilin Hospital
      Affiliated With Jilin University, Jilin, China.
FAU - Kim, Ju Han
AU  - Kim JH
AD  - Chonnam National University Hospital, Gwangju, Republic of Korea.
FAU - Ahn, Youngkeun
AU  - Ahn Y
AD  - Chonnam National University Hospital, Gwangju, Republic of Korea.
FAU - Kim, Young Jo
AU  - Kim YJ
AD  - Yeungnam University Hospital, Daegu, Republic of Korea.
FAU - Cho, Myeong Chan
AU  - Cho MC
AD  - Chungbuk National University Hospital, Cheongju, Republic of Korea.
FAU - Kim, Chong Jin
AU  - Kim CJ
AD  - Kyung Hee University Hospital, Seoul, Republic of Korea.
FAU - Kim, Hyo Soo
AU  - Kim HS
AD  - Seoul National University Hospital, Seoul, Republic of Korea.
FAU - Liu, Bin
AU  - Liu B
AD  - The Second Hospital of Jilin University, Changchun, China.
FAU - Jeong, Myung Ho
AU  - Jeong MH
AD  - The Second Hospital of Jilin University, Changchun, China. Electronic address:
      [email protected]
CN  - Other Korea Acute Myocardial Infarction Registry (KAMIR) Investigators
LA  - eng
PT  - Journal Article
DEP - 20170427
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
EDAT- 2017/05/24 06:00
MHDA- 2017/05/24 06:00
CRDT- 2017/05/24 06:00
PHST- 2017/01/25 [received]
PHST- 2017/04/19 [revised]
PHST- 2017/04/19 [accepted]
AID - S0002-9149(17)30691-4 [pii]
AID - 10.1016/j.amjcard.2017.04.003 [doi]
PST - aheadofprint
SO  - Am J Cardiol. 2017 Apr 27. pii: S0002-9149(17)30691-4. doi:
      10.1016/j.amjcard.2017.04.003.

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