Comparative Effects of Statin Therapy versus Renin-Angiotensin System Blocking Therapy in Patients with Ischemic Heart Failure Who Underwent Percutaneous Coronary Intervention
10.4068/cmj.2016.52.2.128
- Author:
Jumin WON
1
;
Young Joon HONG
;
Myung Ho JEONG
;
Hyuk Jin PARK
;
Min Chul KIM
;
Woo Jin KIM
;
Hyun Kuk KIM
;
Doo Sun SIM
;
Ju Han KIM
;
Youngkeun AHN
;
Jeong Gwan CHO
;
Jong Chun PARK
Author Information
1. Division of Cardiology, Chonnam National University Hospital, Cardiovascular Convergence Research Center Nominated by Korea Ministry of Health and Welfare, Gwangju, Korea. hyj200@hanmail.net
- Publication Type:Original Article
- Keywords:
Myocardial Infarction;
Heart failure;
Hydroxymethylglutaryl-CoA Reductase Inhibitors;
Renin-Angiotensin System
- MeSH:
Follow-Up Studies;
Heart Failure;
Heart;
Humans;
Hydroxymethylglutaryl-CoA Reductase Inhibitors;
Incidence;
Korea;
Multivariate Analysis;
Myocardial Infarction;
Percutaneous Coronary Intervention;
Renin-Angiotensin System;
Stroke Volume
- From:Chonnam Medical Journal
2016;52(2):128-135
- CountryRepublic of Korea
- Language:English
-
Abstract:
Statins and renin-angiotensin system (RAS) blockers are key drugs for treating patients with an acute myocardial infarction (AMI). This study was designed to show the association between treatment with statins or RAS blockers and clinical outcomes and the efficacy of two drug combination therapies in patients with ischemic heart failure (IHF) who underwent revascularization for an AMI. A total of 804 AMI patients with a left ventricular ejection fraction <40% who undertook percutaneous coronary interventions (PCI) were analyzed using the Korea Acute Myocardial Infarction Registry (KAMIR). They were divided into four groups according to the use of medications [Group I: combination of statin and RAS blocker (n=611), Group II: statin alone (n=112), Group III: RAS blocker alone (n=53), Group IV: neither treatment (n=28)]. The cumulative incidence of major adverse cardiac and cerebrovascular events (MACCEs) and independent predictors of MACCEs were investigated. Over a median follow-up study of nearly 1 year, MACCEs had occurred in 48 patients (7.9%) in Group I, 16 patients (14.3%) in Group II, 3 patients (5.7%) in Group III, 7 patients (21.4%) in Group IV (p=0.013). Groups using RAS blocker (Group I and III) showed better clinical outcomes compared with the other groups. By multivariate analysis, use of RAS blockers was the most powerful independent predictor of MACCEs in patients with IHF who underwent PCI (odds ratio 0.469, 95% confidence interval 0.285-0.772; p=0.003), but statin therapy was not found to be an independent predictor. The use of RAS blockers, but not statins, was associated with better clinical outcomes in patients with IHF who underwent PCI.
