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Circ J. 2018 Mar 23;82(4):1112-1120. doi: 10.1253/circj.CJ-17-1221. Epub 2018 Feb 28.

Effects of Statin Intensity on Clinical Outcome in Acute Myocardial Infarction Patients.

Author information

1
Department of Internal Medicine and Cardiovascular Center, Seoul National University Hospital.
2
Department of Internal Medicine and Cardiovascular Center, Chosun University Hospital, University of Chosun College of Medicine.
3
Division of Cardiology, Department of Internal Medicine, Heart Vascular Stroke Institute, Samsung Medical Center, Sungkyunkwan University School of Medicine.
4
National Maritime Medical Center.
5
Department of Cardiology, Yeungnam University Medical Center.
6
Department of Internal Medicine, Kyungpook National University Hospital.
7
Cardiology Division, Department of Internal Medicine, Chungbuk National University Hospital.
8
Department of Internal Medicine, Kyunghee University College of Medicine.
9
Department of Internal Medicine and Heart Center, Chonnam National University Hospital.

Abstract

BACKGROUND:

There has been debate regarding the added benefit of high-intensity statins compared with low-moderate-intensity statins, especially in patients with acute myocardial infarction (AMI).Methods and Results:The Korea Acute Myocardial Infarction Registry-National Institutes of Health consecutively enrolled 13,104 AMI patients. Of these, a total of 12,182 patients, who completed 1-year follow-up, were included in this study, and all patients were classified into 3 groups (no statin; low-moderate-intensity statin; and high-intensity statin). The primary outcome was major adverse cardiac event (MACE) including cardiac death, non-fatal MI, and repeat revascularization at 1 year. Both low-moderate-intensity and high-intensity statin significantly reduced low-density lipoprotein cholesterol (LDL-C; all P<0.001). Compared with the no statin group, both statin groups had significantly lower risk of MACE (low-moderate intensity: HR, 0.506; 95% CI: 0.413-0.619, P<0.001; high intensity: HR, 0.464; 95% CI: 0.352-0.611, P<0.001). The risk of MACE, however, was similar between the low-moderate- and high-intensity statin groups (HR, 0.917; 95% CI: 0.760-1.107, P=0.368). Multivariable adjustment, propensity score matching, and inverse probability weighted analysis also produced the same results.

CONCLUSIONS:

When adequate LDL-C level is achieved, patients on a low-moderate-intensity statin dose have similar cardiovascular outcomes to those on high-intensity statins.

KEYWORDS:

Acute myocardial infarction; Outcome; Percutaneous coronary intervention; Prognosis; Statin

PMID:
29491327
DOI:
10.1253/circj.CJ-17-1221
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