The prognostic significance of statin therapy in acute myocardial infarction patients with left ventricular dysfunction.
- Author:
Young Joon HONG
1
;
Myung Ho JEONG
;
Ji Hyun LIM
;
Hyung Wook PARK
;
Han Gyun KIM
;
Ok Young PARK
;
Ju Han KIM
;
Weon KIM
;
Young Keun AHN
;
Jeong Gwan CHO
;
Sun Pal SUH
;
Byoung Hee AHN
;
Jong Chun PARK
;
Sang Hyung KIM
;
Jung Chaee KANG
Author Information
1. The Heart Center of Chonnam National University Hospital, Chonnam National University Research Institute of Medical Sciences, Gwangju, Korea. myungho@chollian.net
- Publication Type:Original Article
- Keywords:
Statins;
Myocardial Infarction;
Heart failure;
Cholesterol;
Inflammation;
Survival
- MeSH:
C-Reactive Protein;
Cholesterol;
Coronary Artery Disease;
Disease-Free Survival;
Fibrinogen;
Follow-Up Studies;
Heart Failure;
Humans;
Hydroxymethylglutaryl-CoA Reductase Inhibitors*;
Inflammation;
Leukocytes;
Male;
Monocytes;
Mortality;
Myocardial Infarction*;
Percutaneous Coronary Intervention;
Simvastatin;
Triglycerides;
Ventricular Dysfunction, Left*
- From:Korean Journal of Medicine
2004;66(6):576-585
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
BACKGROUND: Statins reduce mortality of patients with coronary artery disease. However, many trials have excluded patients with ischemic heart failure. Statins may have other beneficial effects besides cholesterol lowering, such as anti-inflammatory properties and improvement of endothelial function. The aim of this study was to determine the effects of statin therapy in acute myocardial infarction (AMI) patients with left ventricular (LV) dysfunction. METHODS: We studied 202 patients with AMI with LV dysfunction [ejection fraction (EF) below 40%] between January 2001 and June 2002. The patients were divided into two groups: Group I (n=106, 60.8 +/- 10.3 years, male 71.7%) who were treated with simvastatin and Group II (n=96, 60.9 +/- 10.4 years, male 78.1%) who were not treated with simvastatin. RESULTS: At six-month after percutaneous coronary intervention (PCI), LVEF was more improved in Group I than in Group II (30.8 +/- 10.0% to 42.4 +/- 10.7% vs 31.9% to 38.9%, p=0.042). The levels of total cholesterol, triglyceride and low density lipoprotein-cholesterol were more decreased and the level of high density lipoprotein-cholesterol was more increased in Group I than in Group II. The levels of C-reactive protein, fibrinogen, white blood cell and monocyte count were more decreased in Group I than in Group II. During one-year clinical follow-up, statin therapy was associated with a significant reduction in mortality (1.9% vs 7.5%, p=0.048), restenosis rate (25.7% vs 43.1%, p=0.033) and repeat PCI rate (25.7% vs 43.1%, p=0.033). The event-free survival rate was higher in Group I than in Group II (79.8% vs 57.0%, p=0.001). CONCLUSION: Statin therapy improves LV systolic function and decreases mortality, restenosis and repeat PCI in the AMI with LV dysfunction.
