Intensity of Statin Treatment in Korean Patients with Acute Myocardial Infarction and Very Low LDL Cholesterol
10.12997/jla.2019.8.2.208
- Author:
Doo Sun SIM
1
;
Myung Ho JEONG
;
Hyo Soo KIM
;
Hyeon Cheol GWON
;
Ki Bae SEUNG
;
Seung Woon RHA
;
Shung Chull CHAE
;
Chong Jin KIM
;
Kwang Soo CHA
;
Jong Seon PARK
;
Jung Han YOON
;
Jei Keon CHAE
;
Seung Jae JOO
;
Dong Ju CHOI
;
Seung Ho HUR
;
In Whan SEONG
;
Myeong Chan CHO
;
Doo Il KIM
;
Seok Kyu OH
;
Tae Hoon AHN
;
Jin Yong HWANG
;
Author Information
1. Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea. myungho@chollian.net
- Publication Type:Original Article
- Keywords:
Cholesterol;
Myocardial infarction;
Statins
- MeSH:
Cholesterol;
Cholesterol, LDL;
Death;
Hemorrhage;
Humans;
Hydroxymethylglutaryl-CoA Reductase Inhibitors;
Incidence;
Korea;
Lipoproteins;
Myocardial Infarction;
Stroke
- From:Journal of Lipid and Atherosclerosis
2019;8(2):208-220
- CountryRepublic of Korea
- Language:English
-
Abstract:
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.
