Benefit of Early Statin Initiation within 48 Hours after Admission in Statin-Naïve Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention

Korean Circulation Journal
Min Chul KimKi Bae Seung

Abstract

Although current guidelines recommend early initiation of statin in patients with acute myocardial infarction (AMI), there is no consensus for optimal timing of statin initiation. A total of 3,921 statin-naïve patients undergoing percutaneous coronary intervention were analyzed, and divided into 3 groups according to statin initiation time: group 1 (statin initiation <24 hours after admission), group 2 (24-48 hours) and group 3 (≥48 hours). We also made 3 stratified models to reduce bias: model 1 (<24 hours vs. ≥24 hours), model 2 (<48 hours vs. ≥48 hours) and model 3 (<24 hours vs. 24-48 hours). The endpoint was major adverse cardiac events (MACE; composite of cardiac death, myocardial infarction and target-vessel revascularization) during median 3.8 years. During follow-up, incidence of MACE was lower in early statin group in both model 1 (14.3% vs. 18.4%, hazard ratio [HR], 0.77; 95% confidence interval [CI], 0.66-0.91; p=0.002) and model 2 (14.6% vs. 19.7%, HR, 0.81; 95% CI, 0.67-0.97; p=0.022). After propensity-score matching, results remained unaltered. Statin initiation <24 hours reduced MACE compared to statin initiation ≥24 hours in model 1. Statin initiation <48 hours also reduced MACE compared to statin initiation la...Continue Reading

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Citations

Mar 21, 2019·Korean Circulation Journal·Han Saem Jeong, Soon Jun Hong
Aug 29, 2019·Korean Circulation Journal·Hyoung Mo YangSeung Jea Tahk
Sep 25, 2020·Korean Circulation Journal·Hyun Kuk KimUNKNOWN Task Force on Expert Consensus Document of the Korean Society of Myocardial Infarction (KSMI)

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Clinical Trials Mentioned

NCT02385682

Software Mentioned

SPSS
COREA
R Foundation for Statistical
AMI

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