Benefit of Early Statin Therapy in Patients With Acute Myocardial Infarction Who Have Extremely Low Low-Density Lipoprotein Cholesterol

Title
Benefit of Early Statin Therapy in Patients With Acute Myocardial Infarction Who Have Extremely Low Low-Density Lipoprotein Cholesterol
Author(s)
김영조이기홍[이기홍]정명호[정명호]김하미[김하미]안영건[안영건]김정현[김정현]채정철[채정철]허정호[허정호]정인완[정인완]홍택정[홍택정]최동훈[최동훈]조명찬[조명찬]김종진[김종진]김종진[김종진]성기배[성기배]정욱성[정욱성]장양수[장양수]라성운[라성운]배장호[배장호]조정관[조정관]박성정[박성정]
Keywords
ACUTE CORONARY SYNDROMES; RANDOMIZED CONTROLLED-TRIALS; METAANALYSIS; OUTCOMES; EVENTS; ATORVASTATIN; SIMVASTATIN; PRAVASTATIN; DISEASE; MG/DL
Issue Date
201110
Publisher
ELSEVIER SCIENCE INC
Citation
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, v.58, no.16, pp.1664 - 1671
Abstract
Objectives We investigated whether statin therapy could be beneficial in patients with acute myocardial infarction (AMI) who have baseline low-density lipoprotein cholesterol (LDL-C) levels below 70 mg/dl. Background Intensive lipid-lowering therapy with a target LDL-C value < 70 mg/dl is recommended in patients with very high cardiovascular risk. However, whether to use statin therapy in patients with baseline LDL-C levels below 70 mg/dl is controversial. Methods We analyzed 1,054 patients with AMI who had baseline LDL-C levels below 70 mg/dl and survived at discharge from the Korean Acute MI Registry between November 2005 and December 2007. They were divided into 2 groups according to the prescribing of statins at discharge (statin group n = 607; nonstatin group n = 447). The primary endpoint was the composite of 1-year major adverse cardiac events, including death, recurrent MI, target vessel revascularization, and coronary artery bypass grafting. Results Statin therapy significantly reduced the risk of the composite primary endpoint (adjusted hazard ratio [HR]: 0.56; 95% confidence interval [CI]: 0.34 to 0.89; p = 0.015). Statin therapy reduced the risk of cardiac death (HR: 0.47; 95% CI: 0.23 to 0.93; p = 0.031) and coronary revascularization (HR: 0.45, 95% CI: 0.24 to 0.85; p = 0.013). However, there were no differences in the risk of the composite of all-cause death, recurrent MI, and repeated percutaneous coronary intervention rate. Conclusions Statin therapy in patients with AMI with LDL-C levels below 70 mg/dl was associated with improved clinical outcome. (J Am Coll Cardiol 2011;58:1664-71) (C) 2011 by the American College of Cardiology Foundation
URI
http://hdl.handle.net/YU.REPOSITORY/24416http://dx.doi.org/10.1016/j.jacc.2011.05.057
ISSN
0735-1097
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의과대학 > 내과학교실 > Articles
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