Key result
Prior statin use in ACS patients undergoing PCI was associated with lower in-hospital MACCE (3.7% vs. 5.7%), but was not an independent predictor of MACCE.
Why the study?
Does prior statin use improve in-hospital outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention?
Cohort (n=2,202)
Yes
Does prior statin use improve in-hospital outcomes in patients with acute coronary syndrome undergoing percutaneous coronary intervention?
Absolute Event Rate: 3.7% vs 5.7%
Prior statin use is associated with higher procedural success and lower unadjusted in-hospital MACCE rates in ACS patients undergoing PCI, though it is not an independent predictor of MACCE.
Should not yet change practice in ACS-PCI; leaves open whether prior statin use independently affects in-hospital MACCE.
Background The use of statins prior to percutaneous coronary intervention (PCI) has reduced cardiac events in both short and long-term follow-up. This study assessed the impact of prior statin use on in-hospital PCI outcomes in patients with acute coronary syndrome (ACS). Methods Retrospective analysis of a multicenter registry of 6,288 consecutive patients undergoing PCI. Of these, 35% had ACS and were evaluated according to statin use (Group 1, n = 1,203) or no use (Group 2, n = 999). Results Group 1 showed higher prevalence of dyslipidemia, acute myocardial infarction (AMI), previous coronary artery bypass graft, chronic renal failure, multivessel involvement, bifurcation lesions, and use of drug-eluting stents. Group 2 showed more primary and rescue PCIs, Killip functional class III/IV, B2/C lesions, thrombi, total occlusions, pre-procedural TIMI 0/1 flow, presence of collateral circulation, and use of glycoprotein IIb/IIIa inhibitors and aspiration catheters. PCI success was higher in Group 1 (95.1% vs. 92.5%; p = 0.01), and the occurrence of major adverse cerebrovascular and cardiac events (MACCE) (3.7% vs. 5.7%) was more frequent in Group 2. Although the non-use of statins showed an association with MACCE in the univariate analysis, independent predictors of in-hospital MACCE were limited to AMI in Killip III/IV and prior coronary artery bypass graft. Conclusions ACS patients undergoing PCI who previously used statins had better in-hospital clinical outcomes; however, statin use was not an independent predictor of MACCE.
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Cantarelli et al. (2015) conducted a cohort in Acute coronary syndrome (n=2,202). Prior statin use vs. No prior statin use was evaluated on Major adverse cerebrovascular and cardiac events (MACCE). Prior statin use in ACS patients undergoing PCI was associated with lower in-hospital MACCE (3.7% vs. 5.7%), but was not an independent predictor of MACCE.
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