Key result
In patients with acute myocardial infarction, prediabetes and type 2 diabetes mellitus groups showed comparable incidences of major adverse cardiac events after receiving either high-intensity (aHR 1.059) or low-moderate-intensity statin treatments.
Why the study?
Comparative studies regarding the long-term clinical outcomes of statin intensity between AMI patients with prediabetes and type 2 diabetes mellitus after successful newer-generation DES implantation are limited.
Does high-intensity statin therapy reduce major adverse cardiac events compared to low-moderate-intensity statin therapy in AMI patients with prediabetes or T2DM after newer-generation DES implantation?
Observational (n=11,612)
Yes
Does high-intensity statin therapy reduce major adverse cardiac events compared to low-moderate-intensity statin therapy in AMI patients with prediabetes or T2DM after newer-generation DES implantation?
While overall retrospective cohort results showed comparable outcomes across statin intensities, high-intensity statin therapy may offer superior cardiovascular event reduction compared to low-moderate intensity therapy in contemporary AMI patients post-DES.
Answers are grounded in this paper and cite their sources.
Comparable MACE rates across statin intensities in prediabetes and diabetes warrant caution; leaves open glycemic modification of benefit in AMI.
BACKGROUND: Comparative studies regarding the long-term clinical outcomes of statin intensity between acute myocardial infarction (AMI) patients with prediabetes and those with type 2 diabetes mellitus (T2DM), after successful implantation of newer-generation drug-eluting stents (DES) with statin treatment, are limited. We compared the 2-year clinical outcomes between these patients. METHODS: A total of 11,612 AMI patients were classified as statin users (n = 9893) and non-users (n = 1719). Thereafter, statin users were further divided into high-intensity (n = 2984) or low-moderate-intensity statin (n = 6909) treatment groups. Those in these two groups were further classified into patients with normoglycemia, prediabetes, and T2DM. The major outcomes were the occurrence of major adverse cardiac events (MACE), defined as all-cause death, recurrent myocardial infarction (Re-MI), or any repeat coronary revascularization. RESULTS: After adjusting for both high-intensity and low-moderate-intensity statin users, the cumulative incidences of MACE (p = 0.737, p = 0.062, respectively), all-cause death, Re-MI, and any repeat revascularization were similar between the prediabetes and T2DM groups. In the total study population, both high-intensity and low-moderate-intensity statin treatments showed comparable results. However, in the patients who enrolled after October 2012, the cumulative incidences of MACE (aHR 1.533; 95% CI 1.144-2.053; p = 0.004) and any repeat revascularization (aHR, 1.587; 95% CI 1.026-2.456; p = 0.038) were significantly lower in high-intensity statin users than in low-moderate intensity statin users. The beneficial effects of high-intensity compared to low-moderate-intensity statin therapy were more apparent in the normoglycemia group than hyperglycemia group, as it reduced the cumulative incidences of MACE (aHR 1.903; 95% CI 1.203-3.010; p = 0.006) and any repeat revascularization (aHR 3.248; 95% CI 1.539-6.854; p = 0.002). CONCLUSIONS: In this retrospective registry study, prediabetes and T2DM groups showed comparable clinical outcomes, after administering both high-intensity and low-moderate-intensity statin treatments. However, these results are likely to be clearly proved by further studies, especially in patients with AMI who are being treated in contemporary practice. TRIAL REGISTRATION: Retrospectively registered.
No takes yet. Share an insight, caveat, or question.
Kim et al. (2021) conducted an observational in Acute myocardial infarction (AMI) (n=11,612). Prediabetes vs. Type 2 diabetes mellitus was evaluated on Major adverse cardiac events (MACE) (aHR 1.059, 95% CI 0.760-1.474, p=0.737). In patients with acute myocardial infarction, prediabetes and type 2 diabetes mellitus groups showed comparable incidences of major adverse cardiac events after receiving either high-intensity (aHR 1.059) or low-moderate-intensity statin treatments.
Synapse has enriched 10 related papers. Consider them for comparative context: