Early statin initiation after AMI improves 1-year outcomes
MedWire News: Early initiation of statin therapy in patients with acute myocardial infarction (AMI) is associated with improved clinical outcomes at 1 year, study findings suggest.
The research was undertaken by Youngkeun Ahn (Chonnam National University Hospital, Republic of Korea) and co-workers, and included a series of 1159 patients who were admitted to hospital with AMI over a 3-year period.
All patients were prescribed a statin during admission. For the analysis they were grouped according to the timing of statin initiation: 48 hours or less after admission (n=945) or more than 48 hours afterwards (n=214).
In-hospital mortality rates did not differ between the two groups, report Ahn et al.
At 30 days, the groups had similar rates of cardiac death, nonfatal MI, and coronary artery bypass grafting, but repeat percutaneous coronary intervention (PCI) was more frequent in the group with later statin initiation (3.8% vs 1.1%).
At 1 year, rates of major adverse cardiac events (MACE) and repeat PCI were 17.8% and 10.2%, respectively in the earlier statin initiation group and 24.6% and 15.5%, respectively, in the later statin initiation group. Both differences in outcomes between earlier and later statin initiation were statistically significant.
Mortality did not differ between the groups, however.
In multivariate analysis, late statin initiation was an independent predictor of MACE at 1 year, with an odds ratio of 1.49 compared with early initiation.
Other significant predictors were Killip class IV disease, multivessel disease, use of an intra-aortic balloon pump, reduced systolic function, and receipt of a drug-eluting stent.
Writing in the International Heart Journal, the authors say their study demonstrates the effectiveness of early statin therapy in patients with AMI.
"In conclusion… early statin therapy within 48 hours after admission reduced MACE at one-year follow-up," they write.
"Statin initiation 48 or more hours after admission predicts major adverse cardiac events in patients with AMI."
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By Joanna Lyford