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Effect of Statin Treatment in Patients With Acute Myocardial Infarction and Left Ventricular Systolic Dysfunction According to the Level of High-Sensitivity C-Reactive Protein.
MedLine Citation:
PMID:  24632965     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
The effects of statins on the prognosis of patients with left ventricular (LV) systolic dysfunction remain controversial. The aim of this study was to assess the effect of statin treatment on clinical outcomes in acute myocardial infarction (AMI) patients with LV systolic dysfunction. A total of 5,119 AMI patients with LV ejection fraction less than 50% on the initial echocardiogram were analyzed in the Korean Acute Myocardial Infarction Registry. The study population was divided into 4 groups according to the level of high sensitivity C-reactive protein (hs-CRP) and statin treatment: low hs-CRP (hs-CRP ≤ 2.0 mg/L) and high hs-CRP (hs-CRP > 2 mg/L) with or without statin therapy. We evaluated the incidence of major adverse cardiac events (MACEs) including cardiac death, reinfarction, target lesion revascularization, and coronary artery bypass grafting during a 12-month period in each group. Statin therapy did not signifi cantly prevent the MACEs in the low hs-CRP groups (with statin: 10.1% versus without statin: 12.0%, P = 0.249). In the high hs-CRP groups, however, the incidence of MACEs was significantly decreased with statin treatment (with statin: 11.3%, without statin: 20.8%, P < 0.001). These findings were consistently observed in all subgroups of the high-hs CRP group, including the subgroup with an LV ejection fraction less than 40%. In a multivariable logistic regression analysis of the high hs-CRP group, lack of statin therapy was a significant predictor of MACE incidence (odds ratio: 1.573, 95% confi dence interval: 1.079-2.293, P = 0.018). The statin treatment was associated with better outcome in AMI and LV dysfunction patients with hs-CRP ≥ 2 mg/dL.
Authors:
Hae Chang Jeong; Youngkeun Ahn; Keun-Ho Park; Doo Sun Sim; Young Joon Hong; Ju Han Kim; Myung Ho Jeong; Young Jo Kim; Shung Chull Chae; Myeong Chan Cho; Jei Keon Chae; Chong Jin Kim; Seung-Woon Rha; Yang Soo Jang; Seok Kyu Oh; In Whan Seong; Kwang Soo Cha
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2014-3-14
Journal Detail:
Title:  International heart journal     Volume:  -     ISSN:  1349-3299     ISO Abbreviation:  Int Heart J     Publication Date:  2014 Mar 
Date Detail:
Created Date:  2014-3-17     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101244240     Medline TA:  Int Heart J     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
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