Document Detail


Association between time of statin initiation after hospital discharge from acute myocardial infarction and risk of recurrence and mortality in patients > or =65 years of age.
MedLine Citation:
PMID:  16442354     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Clinical studies have shown the benefit of statin use after acute myocardial infarction (AMI). However, it is uncertain how this benefit relates to the timing of statin initiation after AMI. We created a retrospective cohort (from 1996 to 2001) using health care databases in Quebec, Canada, to study patients (> or =65 years of age) who had AMI and differed in time of statin initiation within the first 90 days after discharge. Rates of recurrent AMI and mortality were compared between patients who initiated statins at discharge (early group) and those who initiated statins 1 month later and up to 90 days after discharge (delayed group). A multivariate Cox's regression model was used in the comparison. We used prescription time distribution matching to control for survival difference between groups. The early and delayed groups consisted of 3,075 and 1,187 patients, respectively. During the 1-year follow-up, there was no evidence to suggest a difference in outcome between groups. Adjusted hazard ratios for early versus delayed initiation were 1.03 (95% confidence interval 0.56 to 1.87) at 3 months and 1.24 (95% confidence interval 0.96 to 1.62) at 1 year. Analyses that were restricted to first-time statin users or excluded patients who had severe co-morbidity or were > or =85 years old did not change the results. Our findings were not affected by changing the definition of delayed use within the 90-day period. In conclusion, delay of statin initiation up to 30 to 90 days after discharge after AMI does not appear to lead to a difference in the rates of recurrent AMI and mortality compared with statin initiation at discharge.
Authors:
Zheng Zhou; Elham Rahme; Louise Pilote
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't     Date:  2005-11-16
Journal Detail:
Title:  The American journal of cardiology     Volume:  97     ISSN:  0002-9149     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2006 Jan 
Date Detail:
Created Date:  2006-01-30     Completed Date:  2006-03-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  155-9     Citation Subset:  AIM; IM    
Affiliation:
Department of Epidemiology and Biostatistics, McGill University, Montreal, Quebec, Canada.
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MeSH Terms
Descriptor/Qualifier:
Aged
Female
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
Male
Myocardial Infarction / drug therapy*,  epidemiology*,  mortality
Quebec
Recurrence / prevention & control
Retrospective Studies
Time Factors
Treatment Outcome
Chemical
Reg. No./Substance:
0/Hydroxymethylglutaryl-CoA Reductase Inhibitors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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