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Impact of statin therapy on long-term clinical outcomes between STEMI and NSTEMI after stent implantation
Authors : YH Kim (Chuncheon,KR), A-Y Her (Chuncheon,KR), MH Jeong (Gwangju,KR), B-K Kim (Seoul,KR), S-Y Lee (Gunpo,KR), S-J Hong (Seoul,KR), D-H Shin (Seoul,KR), C-M Ahn (Seoul,KR), J-S Kim (Seoul,KR), Y-G Ko (Seoul,KR), D Choi (Seoul,KR), M-K Hong (Seoul,KR), Y Jang (Seoul,KR)
YH Kim1
,
A-Y Her1
,
MH Jeong2
,
B-K Kim3
,
S-Y Lee4
,
S-J Hong3
,
D-H Shin3
,
C-M Ahn3
,
J-S Kim3
,
Y-G Ko3
,
D Choi3
,
M-K Hong3
,
Y Jang3
,
1Kangwon National University School of Medicine - Chuncheon - Korea (Republic of)
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2Chonnam National University Hospital, Department of Cardiology - Gwangju - Korea (Republic of)
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3Severance Cardiovascular Hospital, Division of Cardiology, Yonsei University College of Medicine - Seoul - Korea (Republic of)
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4Sanbon Hospital, Wonkwang University College of Medicine, Department of Cardiology - Gunpo - Korea (Republic of)
,
Citation:
Background: Although European guideline recommends that statin should be given to all patients with acute myocardial infarction (AMI), irrespective of cholesterol concentration, limited studies were focused on the long-term effects of statin therapy between ST-segment elevation MI (STEMI) and non-ST-segment elevation MI (NSTEMI).
Purpose: The authors conducted the study to compare the relative beneficial role of statin on 2-year major clinical outcomes between STEMI and NSTEMI in patients who underwent successful PCI with DES.
Methods: Finally, a total of 26317 AMI patients who underwent stent implantation and who were prescribed the statin were enrolled and they were separated into two groups; the STEMI group (n = 15002) and the NSTEMI group (n = 11315). The clinical endpoint was the occurrence of major adverse cardiac events (MACE) defined as all-cause death, recurrent myocardial infarction (re-MI), total coronary revascularization (target lesion revascularization [TLR], target vessel revascularization [TVR], non-TVR) during 2-year follow-up period.
Results: After propensity score-matched (PSM) analysis, two PSM groups (7746 pairs, n = 15492, C-statistic = 0.766) were generated. In the total study population, the cumulative incidences of MACE, all-cause death, and cardiac death were significantly higher in the NSTEMI group. However, after PSM, the cumulative incidence of all-cause death (Hazard ratio, 1.386; 95% CI, 1.133–1.696; p = 0.002) was significantly higher in the NSTEMI group. The cumulative incidences of MACE, cardiac death, re-MI, total revascularization, TLR, TVR, and non-TVR were similar between the two groups (Table 1).
Conclusion: The mortality reduction capability of statin was more prominent in the STEMI group compared with the NSTEMI group.
ESC 365 is supported by Bayer, Boehringer Ingelheim and Lilly Alliance, Bristol-Myers Squibb and Pfizer Alliance, Novartis Pharma AG and Vifor Pharma in the form of educational grants. The sponsors were not involved in the development of this platform and had no influence on its content.
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