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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)
Y.H. Kim1
,
A.-Y. Her1
,
M.H. 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 City - Korea (Republic of)
,
2Chonnam National University Hospital, Department of Cardiology - Gwangju - Korea (Republic of)
,
3Severance Cardiovascular Hospital, Division of Cardiology, Yonsei University College of Medicine - Seoul - Korea (Republic of)
,
4Sanbon Hospital, Wonkwang University College of Medicine, Department of Cardiology - Gunpo - Korea (Republic of)
,
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.
