Erschienen in:
03.09.2020 | Original Article
Impact of high-dose statin on cardiovascular outcomes in real-world patients with ST-elevation acute myocardial infarction
verfasst von:
Takenobu Shimada, Kohei Osakada, Koya Okabe, Yuki Shima, Haruki Eguchi, Seiji Habara, Takeshi Tada, Yuya Taguchi, Akihiro Ikuta, Makoto Takamatsu, Ryosuke Murai, Katsuya Miura, Masanobu Ohya, Hidewo Amano, Shunsuke Kubo, Hiroyuki Tanaka, Takeshi Maruo, Yasushi Fuku, Harumi Katoh, Tsuyoshi Goto, Kazushige Kadota
Erschienen in:
Heart and Vessels
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Ausgabe 3/2021
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Abstract
Little is known about the impact of a high-dose statin on cardiovascular outcomes after ST-elevation acute myocardial infarction (STEMI) in real-world Japanese patients. Between July 2011 and June 2017, 1110 consecutive STEMI patients underwent primary percutaneous coronary intervention at our hospital and were discharged. A high-dose statin was administered in 117 patients (10.5%) and non-high-dose statin was administered in 947 patients (85.3%). The low-density lipoprotein cholesterol level was significantly higher in the high-dose statin group at admission (129.8 ± 44.9 vs. 110.4 ± 32.7, p < 0.0001), but the levels were not significantly different at follow-up (86.7 ± 25.7 vs. 85.0 ± 25.0, p = 0.52). The cumulative 2-year incidence of a composite of cardiac death, myocardial infarction, ischemic stroke, and any unplanned coronary revascularization was significantly lower in the high-dose statin group (6.2% vs. 16.9%, log-rank p = 0.004). Propensity score matched analysis indicated similar results. Among the types of coronary revascularization, a high-dose statin was significantly correlated with a lower rate of de novo lesion revascularization (hazard ratio 0.31; 95% confidence interval 0.08–0.83; p = 0.02). The results of our analyses indicate that administration of a high-dose statin may result in better cardiovascular outcomes after STEMI mainly by reducing the rate of revascularization for de novo lesions regardless of the achieved low-density lipoprotein cholesterol level in real-world patients.