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Am J Cardiol. 2017 Jul 15;120(2):174-180. doi: 10.1016/j.amjcard.2017.04.003. Epub 2017 Apr 27.

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

Author information

1
The Second Hospital of Jilin University, Changchun, China; Chonnam National University Hospital, Gwangju, Republic of Korea.
2
The Second Hospital of Jilin University, Changchun, China; Jilin Hospital Affiliated With Jilin University, Jilin, China.
3
Chonnam National University Hospital, Gwangju, Republic of Korea.
4
Yeungnam University Hospital, Daegu, Republic of Korea.
5
Chungbuk National University Hospital, Cheongju, Republic of Korea.
6
Kyung Hee University Hospital, Seoul, Republic of Korea.
7
Seoul National University Hospital, Seoul, Republic of Korea.
8
The Second Hospital of Jilin University, Changchun, China.
9
The Second Hospital of Jilin University, Changchun, China. Electronic address: myungho@chollian.net.

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:
28532771
DOI:
10.1016/j.amjcard.2017.04.003
[Indexed for MEDLINE]

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