Effects of Statin Intensity on Clinical Outcome in Acute Myocardial Infarction Patients.

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Effects of Statin Intensity on Clinical Outcome in Acute Myocardial Infarction Patients.

Circ J. 2018 Feb 28;:

Authors: Hwang D, Kim HK, Lee JM, Choi KH, Kim J, Rhee TM, Park J, Park TK, Yang JH, Song YB, Choi JH, Hahn JY, Choi SH, Koo BK, Kim YJ, Chae SC, Cho MC, Kim CJ, Gwon HC, Jeong MH, Kim HS, KAMIR Investigators

BACKGROUND: There has been debate regarding the added benefit of high-intensity statins compared with low-moderate-intensity statins, especially in patients with acute myocardial infarction (AMI).Methods and Results:The Korea Acute Myocardial Infarction Registry-National Institutes of Health consecutively enrolled 13,104 AMI patients. Of these, a total of 12,182 patients, who completed 1-year follow-up, were included in this study, and all patients were classified into 3 groups (no statin; low-moderate-intensity statin; and high-intensity statin). The primary outcome was major adverse cardiac event (MACE) including cardiac death, non-fatal MI, and repeat revascularization at 1 year. Both low-moderate-intensity and high-intensity statin significantly reduced low-density lipoprotein cholesterol (LDL-C; all P<0.001). Compared with the no statin group, both statin groups had significantly lower risk of MACE (low-moderate intensity: HR, 0.506; 95% CI: 0.413-0.619, P<0.001; high intensity: HR, 0.464; 95% CI: 0.352-0.611, P<0.001). The risk of MACE, however, was similar between the low-moderate- and high-intensity statin groups (HR, 0.917; 95% CI: 0.760-1.107, P=0.368). Multivariable adjustment, propensity score matching, and inverse probability weighted analysis also produced the same results.
CONCLUSIONS: When adequate LDL-C level is achieved, patients on a low-moderate-intensity statin dose have similar cardiovascular outcomes to those on high-intensity statins.

PMID: 29491327 [PubMed - as supplied by publisher]

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