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KMID : 0880520100460010025
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Chonnam Medical Journal
2010 Volume.46 No. 1 p.25 ~ p.31
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Early Initiation of Statin Treatment Immediately after Acute Myocardial Infarction Improves Clinical Outcomes
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Hong Young-Joon
Jeong Myung-Ho
Park Keun-Ho
Sim Doo-Sun
Kim Kye-Hun
Kim Ju-Han
Ahn Young-Keun
Cho Jeong-Gwan
Park Jong-Chun
Kang Jung-Chaee
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Abstract
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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.
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KEYWORD
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Myocardial infarction, Inflammation, Lipids, Antilipemic agents
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