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KMID : 1036020190080020208
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지질.동맥경화학회지
2019 Volume.8 No. 2 p.208 ~ p.220
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Intensity of Statin Treatment in Korean Patients with Acute Myocardial Infarction and Very Low LDL Cholesterol
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Sim Doo-Sun
Jeong Myung-Ho
Kim Hyo-Soo
Gwon Hyeon-Cheol
Seung Ki-Bae
Rha Seung-Woon
Chae Shung-Chull
Kim Chong-Jin
Cha Kwang-Soo
Park Jong-Seon
Yoon Jung-Han
Chae Jei-Keon
Joo Seung-Jae
Choi Dong-Ju
Hur Seung-Ho
Seong In-Whan
Cho Myeong-Chan
Kim Doo-Il
Oh Seok-Kyu
Ahn Tae-Hoon
Hwang Jin-Yong
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Abstract
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Objective: Data on the intensity of statin therapy for patients with acute myocardial infarction (MI) and very low baseline low-density lipoprotein (LDL) cholesterol level are lacking. We sought to assess the impact of statin intensity in patients with acute MI and LDL cholesterol <70 mg/dL.
Methods: A total of 1,086 patients with acute MI and baseline LDL cholesterol <70 mg/dL from the Korea Acute Myocardial Infarction Registry-National Institute of Health database were divided into less intensive statin (expected LDL reduction <40%, n=302) and more intensive statin (expected LDL reduction ≥40%, n=784) groups. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCEs), a composite of cardiac death, MI, revascularization occurring at least 30 days after admission, and stroke, at 12 months.
Results: After 1:2 propensity matching, differences were not observed between less intensive (n=302) and more intensive statin (n=604) groups in incidence of cardiac death (0.3% vs. 0.3%) and hemorrhagic stroke (0.3% vs. 0.5%, p=0.727) at 12 months. Compared with the less intensive statin group, the more intensive statin group showed lower target-vessel revascularization (4.6% vs. 1.8%, p=0.027) and MACCE (11.6% vs. 7.0%, p=0.021). Major bleeding was not different between less intensive and more intensive statin groups (1.0% vs. 2.6%, p=0.118).
Conclusion: More intensive statin therapy was associated with significantly lower major adverse cardiovascular events in patients with acute MI and very low LDL cholesterol compared with less intensive statin therapy.
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KEYWORD
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Cholesterol, Myocardial infarction, Statins
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