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Effect of previous statin therapy in patients with acute coronary syndrome and percutaneous coronary intervention.

Abstract：

BACKGROUND AND OBJECTIVES:Statin therapy after percutaneous coronary intervention (PCI) has been associated with reduced major adverse cardiovascular events (MACE). However, it has been less clear as to whether statin therapy before acute coronary syndrome (ACS) is beneficial. We studied the effect of previous statin therapy, initiated ≥1 month before PCI, on the outcome of patients with ACS who had undergone early invasive strategies. SUBJECTS AND METHODS:We stratified 479 consecutive patients with ACS who had undergone PCI, according to preprocedural statin administration as follows: previous statin-treated patients (statin group, n=237) and statin-naive patients (control group, n=242). The incidence of periprocedural myocardial infarction (MI) and in-hospital MACE was assessed. RESULTS:The incidence of Braunwald class III angina and MI presentation were significantly lower in the statin group than in the control group. Angiographic and procedural characteristics were similar between the two groups; however, slow/no reflow phenomenon occurred more frequently in the control group. After PCI, the incidence of periprocedural MI was higher in the control group than in the statin group (6.6% vs. 2.1%, p=0.016). Multivariate analysis revealed that no prior use of statin {odds ratio (OR)=2.8; 95% confidence interval (CI)=1.1-7.2; p=0.038), procedural complication (OR=4.0; 95% CI=1.5-10.5; p=0.004), stent overlap (OR=4.7; 95% CI=1.3-16.4; p=0.015), and old age (OR=3.2; 95% CI=1.2-8.0; p=0.016) were independent predictors for in-hospital MACE. CONCLUSION:Previous statin therapy before ACS was associated with milder clinical presentation and lower incidence of in-hospital MACE after early invasive strategies. The beneficial outcome is attributable to a significant reduction in periprocedural MI after PCI.

journal_name

Korean Circ J

journal_title

Korean circulation journal

authors

Yun KH,Shin IS,Shin SN,Choi JH,Kim SH,Rhee SJ,Lee EM,Yoo NJ,Kim NH,Oh SK,Jeong JW

doi

10.4070/kcj.2011.41.8.458

subject

Has Abstract

pub_date

2011-08-01 00:00:00

pages

458-63

issue

eissn

1738-5520

issn

1738-5555

journal_volume

pub_type

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Effect of previous statin therapy in patients with acute coronary syndrome and percutaneous coronary intervention.