Korean J Intern Med.  2011 Sep;26(3):294-303. 10.3904/kjim.2011.26.3.294.

Comparison of Clinical Outcomes of Hydrophilic and Lipophilic Statins in Patients with Acute Myocardial Infarction

• Kim MC
• Ahn Y
• Jang SY
• Cho KH
• Hwang SH
• Lee MG
• Ko JS
• Park KH
• Sim DS
• Yoon NS
• Yoon HJ
• Kim KH
• Hong YJ
• Park HW
• Kim JH
• Jeong MH
• Cho JG
• Park JC
• Kang JC

• KMID: 1022169
• DOI: http://doi.org/10.3904/kjim.2011.26.3.294

Abstract

BACKGROUND/AIMS
A controversy exists about which statin is preferable for patients with acute myocardial infarction (AMI), and clinical impacts of different statins according to lipophilicity have not been established.
METHODS
The 1,124 patients with AMI included in the present study were divided into hydrophilic- and lipophilic-statin groups. In-hospital complications (defined as death, cardiogenic shock, ventricular arrhythmia, infection, bleeding, and renal insufficiency, and other fatal arrhythmias), major adverse cardiac events (MACE), all-cause death, re-myocardial infarction, re-percutaneous coronary intervention (re-PCI), and surgical revascularization were analyzed during a 1-year clinical follow-up.
RESULTS
Baseline characteristics were similar between the two groups, and in-hospital complication rates showed no between-group differences (11.7% vs. 12.8%, p = 0.688). Although MACE at the 1- and 6-month clinical follow-ups occurred more in hydrophilic statin group I (1 month: 10.0% vs. 4.4%, p = 0.001; 6 month: 19.9% vs. 14.2%, p = 0.022), no significant difference in MACE was observed at the 1-year follow-up (21.5% vs. 17.9%, p = 0.172). Both statin groups showed similar efficacy for reducing serum lipid concentrations. A Cox-regression analysis showed that the use of a hydrophilic statin did not predict 1-year MACE, all-cause death, AMI, or re-PCI.
CONCLUSIONS
Although short-term cardiovascular outcomes were better in the lipophilic-statin group, 1-year outcomes were similar in patients with AMI who were administered hydrophilic and lipophilic statins. In other words, the type of statin did not influence 1-year outcomes in patients with AMI.

Keyword

Hydroxymethylglutaryl-CoA reductase inhibitors; Myocardial infarction

MeSH Terms

Aged
Biological Markers/blood
Cardiovascular Diseases/etiology/prevention & control
Chi-Square Distribution
Female
Hospital Mortality
Humans
Hydrophobic and Hydrophilic Interactions
Hydroxymethylglutaryl-CoA Reductase Inhibitors/adverse effects/chemistry/*therapeutic use
Korea
Lipids/blood
Male
Middle Aged
Myocardial Infarction/blood/complications/diagnosis/mortality/*therapy
Proportional Hazards Models
Recurrence
Retrospective Studies
Risk Assessment
Risk Factors
Time Factors
Treatment Outcome