Differential Benefit of Statin in Secondary Prevention of Acute Myocardial Infarction according to the Level of Triglyceride and High Density Lipoprotein Cholesterol.
10.4070/kcj.2016.46.3.324
- Author:
Kyung Hwan KIM
1
;
Cheol Hwan KIM
;
Myung Ho JEONG
;
Youngkeun AHN
;
Young Jo KIM
;
Myeong Chan CHO
;
Wan KIM
;
Jong Jin KIM
Author Information
1. Chonnam National University Hospital, Gwangju, Korea. mhjeong@chonnam.ac.kr
- Publication Type:Original Article
- Keywords:
Statin;
Acute myocardial infarction;
Triglyceride;
High-density lipoprotein cholesterol;
Prognosis
- MeSH:
Cholesterol, HDL*;
Dyslipidemias;
Humans;
Hydroxymethylglutaryl-CoA Reductase Inhibitors*;
Myocardial Infarction*;
Prognosis;
Secondary Prevention*;
Triglycerides*
- From:Korean Circulation Journal
2016;46(3):324-334
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND AND OBJECTIVES: The differential benefit of statin according to the state of dyslipidemia has been sparsely investigated. We sought to address the efficacy of statin in secondary prevention of myocardial infarction (MI) according to the level of triglyceride and high density lipoprotein cholesterol (HDL-C) on admission. SUBJECTS AND METHODS: Acute MI patients (24653) were enrolled and the total patients were divided according to level of triglyceride and HDL-C on admission: group A (HDL-C≥40 mg/dL and triglyceride<150 mg/dL; n=11819), group B (HDL-C≥40 mg/dL and triglyceride≥150 mg/dL; n=3329), group C (HDL-C<40 mg/dL and triglyceride<150 mg/dL; n=6062), and group D (HDL-C<40 mg/dL & triglyceride≥150 mg/dL; n=3443). We evaluated the differential efficacy of statin according to the presence or absence of component of dyslipidemia. The primary end points were major adverse cardiac events (MACE) for 2 years. RESULTS: Statin therapy significantly reduced the risk of MACE in group A (hazard ratio=0.676; 95% confidence interval: 0.582-0.785; p<0.001). However, the efficacy of statin was not prominent in groups B, C, or D. In a propensity-matched population, the result was similar. In particular, the benefit of statin in group A was different compared with group D (interaction p=0.042) CONCLUSION: The benefit of statin in patients with MI was different according to the presence or absence of dyslipidemia. In particular, because of the insufficient benefit of statin in patients with MI and dyslipidemia, a different lipid-lowering strategy is necessary in these patients.
