Key result
Prior statin therapy is linked to ~39% lower risk of major in-hospital events in STEMI.
Why the study?
Data regarding the cardioprotective effect of prior statin therapy in patients with STEMI undergoing primary PCI remain controversial.
Does prior statin therapy reduce the risk of in-hospital mortality and severe heart failure complications in STEMI patients undergoing primary PCI?
Cohort (n=1,790)
Does prior statin therapy reduce the risk of in-hospital mortality and severe heart failure complications in STEMI patients undergoing primary PCI?
Prior statin therapy for more than 6 months is associated with a reduced risk of in-hospital mortality and severe heart failure complications in STEMI patients undergoing primary PCI.
Answers are grounded in this paper and cite their sources.
May support statin use before STEMI PCI; hypothesis-generating and requires randomized confirmation.
Background: Prior statin therapy has a cardioprotective effect in patients undergoing elective or urgent percutaneous coronary intervention (PCI). However, data on patients with ST-elevation myocardial infarction (STEMI) undergoing primary PCI are still controversial. We retrospectively evaluated the effect of prior statin therapy on in-hospital clinical outcomes in consecutive STEMI patients undergoing primary PCI. Methods: A total of 1790 patients (mean age 67 ± 11 years, 1354 men) were included. At admission, all patients were interrogated about prior (>6 months) statin therapy. The primary endpoint of the study was the composite of in-hospital mortality, acute pulmonary edema, and cardiogenic shock in patients with or without prior statin therapy. Results: A total of 427 patients (24%) were on prior statin therapy. The incidence of the primary endpoint was similar in patients with or without prior statin therapy (15% vs. 16%; p = 0.38). However, at multivariate analysis, prior statin therapy was associated with a lower risk of the primary endpoint, after adjustment for major prognostic predictors (odds ratio 0.61 [95% CI 0.39−0.96]; p = 0.03). Conclusions: This study demonstrated that prior statin therapy is associated with a better in-hospital clinical outcome in patients with STEMI undergoing primary PCI compared to those without prior statin therapy.
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Lanza et al. (2022) conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=1,790). Prior statin therapy (>6 months) vs. No prior statin therapy was evaluated on Composite of in-hospital mortality, acute pulmonary edema, and cardiogenic shock (OR 0.61, 95% CI 0.39-0.96, p=0.03). Prior statin therapy was associated with a lower risk of in-hospital mortality, acute pulmonary edema, and cardiogenic shock in STEMI patients (OR 0.61; 95% CI 0.39-0.96; p=0.03).
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