Chronic statin-use before PCI in acute coronary syndromes and in-hospital outcomes: ACC NCDR registry in India

Objective: To compare in-hospital major cardiovascular adverse outcomes among chronic statin-user and statin-naïve acute coronary syndrome(ACS) patients following percutaneous coronary intervention(PCI). Methods: Successive patients with ACS who underwent PCI from Sep'17 to Dec'23 were enrolled in a prospective registry. Details of risk factors, presentation, angiography, interventions, and in-hospital outcomes were recorded. Chronic statin use was defined as > 1-month intake before presentation. Primary outcomes were in-hospital all-cause and cardiovascular deaths. Univariate and multivariate odds ratios(OR) and 95 % confidence intervals(CI) were calculated. In statin-user vs. statin-naïve groups, the incidence of all-cause deaths: 33(1.12 %) vs 85(1.72 %) (OR 0.65, CI 0.43-0.97) and CV deaths: in 29(0.98 %) vs 73(1.47 %) (OR 0.67, CI 0.43-1.02) were lower. The ORs attenuated following multivariate adjustments for risk factors, previous treatments, clinical features, angiographic findings and interventions. Conclusions: Acute coronary syndrome patients taking pre-admission statins and other cardioprotective medicines have lower in-hospital all-cause deaths. This is associated with less STEMI, better LVEF, and shorter hospitalization in prior statin users.