Background: We investigated whether early statin therapy could be beneficial to reduce acute heart failure (AHF) incidence in patients with ST-elevation myocardial infarction (STEMI) and improve survival during long term follow-up.
Methods: 307 STEMI patients were registered and followed-up prospectively, 128 of them (propensity score matching) were analyzed. 64 patients received any available statin in optimal doses within 6 hours of acute myocardial infarction (AMI) onset or no statin (n=64) and were followed up for 5 years. Reperfusion therapy was performed in 71.9%. The mean time from symptoms onset to hospital admission was 4.9±0.6 hours. We evaluated the effects of statin therapy on major adverse cardiovascular events, including AHF during in-hospital stay, cardiovascular death, non-fatal myocardial infarction and heart failure requiring hospitalization.
Results: Statin therapy significantly reduced the risk of the AHF incidence on the 3d day (p<0.05) and 7th day (p<0.01). We found a distinct loss of renal function of 4.4 ml/min in no-statin group and increase of glomerular filtration rate on 6.5 ml/min in statin group on the 10th day following AMI compare to 1st day (p<0.05 between groups). Statin therapy reduced the risk of cardiovascular death, non-fatal infarction and heart failure requiring hospitalization (p=0.014 by log rank).
Conclusions: The present study showed that early statin therapy in STEMI patients decreased incidence rate of AHF. Statin therapy markedly reduced the risk of the long-term mortality and subsequent cardiac events in AMI patients.