Intensity of Statin Treatment in Korean Patients with Acute Myocardial Infarction and Very Low LDL Cholesterol
- Authors
- 심두선; 정명호; 김효수; 권현철; 승기배; 나승운; 채성철; 김종진; 차광수; 박종선; 윤정한; 채제건; 주승재; 최동주; 허승호; 성인환; 조명찬; 김두일; 오석규; 안태훈; 황진용
- Issue Date
- Sep-2019
- Publisher
- 한국지질동맥경화학회
- Keywords
- Cholesterol; Myocardial infarction; Statins
- Citation
- 지질·동맥경화학회지, v.8, no.2, pp.208 - 220
- Journal Title
- 지질·동맥경화학회지
- Volume
- 8
- Number
- 2
- Start Page
- 208
- End Page
- 220
- URI
- https://scholarworks.bwise.kr/gachon/handle/2020.sw.gachon/2247
- DOI
- 10.12997/jla.2019.8.2.208
- ISSN
- 2287-2892
- Abstract
- Objective Data on the intensity of statin therapy for patients with acute myocardial infarction (MI) and very low baseline low-density lipoprotein (LDL) cholesterol level are lacking. We sought to assess the impact of statin intensity in patients with acute MI and LDL cholesterol <70 mg/dL.
Methods A total of 1,086 patients with acute MI and baseline LDL cholesterol <70 mg/dL from the Korea Acute Myocardial Infarction Registry-National Institute of Health database were divided into less intensive statin (expected LDL reduction <40%, n=302) and more intensive statin (expected LDL reduction ≥40%, n=784) groups. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCEs), a composite of cardiac death, MI, revascularization occurring at least 30 days after admission, and stroke, at 12 months.
Results After 1:2 propensity matching, differences were not observed between less intensive (n=302) and more intensive statin (n=604) groups in incidence of cardiac death (0.3% vs. 0.3%) and hemorrhagic stroke (0.3% vs. 0.5%, p=0.727) at 12 months. Compared with the less intensive statin group, the more intensive statin group showed lower target-vessel revascularization (4.6% vs. 1.8%, p=0.027) and MACCE (11.6% vs. 7.0%, p=0.021). Major bleeding was not different between less intensive and more intensive statin groups (1.0% vs. 2.6%, p=0.118).
Conclusion More intensive statin therapy was associated with significantly lower major adverse cardiovascular events in patients with acute MI and very low LDL cholesterol compared with less intensive statin therapy.
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