Chonnam Med J.  2010 Apr;46(1):25-31. 10.4068/cmj.2010.46.1.25.

Early Initiation of Statin Treatment Immediately after Acute Myocardial Infarction Improves Clinical Outcomes

• Hong YJ
• Jeong MH
• Park KH
• Sim DS
• Kim KH
• Kim JH
• Ahn Y
• Cho JG
• Park JC
• Kang JC

• KMID: 2172253
• DOI: http://doi.org/10.4068/cmj.2010.46.1.25

Abstract

The purpose of the present study was to assess the effects of early initiation of statin treatment on midterm major adverse cardiac events (MACEs) after acute myocardial infarction (AMI). Between October 2005 and December 2006, 621 AMI patients (439 ST-segment and 182 non-ST-segment elevation MI) were registered and followed prospectively. Early initiation of statin treatment was defined as prescription of statins during hospitalization (n=545), and the control group was not prescribed statins (n=76). During the 6-month follow-up, 22 patients died: 7 patients from the control group (9%) and 15 patients from the statin group (3%) (p=0.004). Six-month MACEs (including cardiac death, MI, and target vessel revascularization) occurred less frequently in the statin group than in the control group (14% vs. 24%, p=0.034). Baseline high-sensitivity C-reactive protein (hs-CRP) was significantly higher in patients who experienced cardiac death than in patients without cardiac death (12.8+/-10.2 mg/dl vs. 2.1+/-3.0 mg/dl, p<0.001). Multivariate analysis showed that early statin therapy and the baseline hs-CRP level were independent predictors of 6-month mortality [odds ratio (OR)=0.078, 95% CI: 0.008~0.808, p=0.032, and OR=1.314, 95% CI: 1.149~1.501, p<0.001, respectively). High inflammatory status is associated with poor prognosis, and early initiation of statin treatment after AMI could decrease the mid-term mortality rate.

Keyword

Myocardial infarction; Inflammation; Lipids; Antilipemic agents

MeSH Terms

C-Reactive Protein
Death
Follow-Up Studies
Glycosaminoglycans
Hospitalization
Humans
Hypolipidemic Agents
Inflammation
Multivariate Analysis
Myocardial Infarction
Prescriptions
Prognosis
Prospective Studies
C-Reactive Protein
Glycosaminoglycans
Hypolipidemic Agents

Figure

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  Fig. 1 Incidences of mortality, myocardial infarction (MI), target vessel revascularization (TVR), and total major adverse cardiac events (MACE) in the statin group and nonstatin group at the 6-month follow-up.

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