Key result
Pre-discharge statins linked to ~67% lower 6-month MACE in elderly AMI patients with LV dysfunction.
Why the study?
Does statin therapy reduce 6-month MACE in elderly patients with AMI and left ventricular dysfunction who underwent PCI?
Cohort (n=179)
No
Does statin therapy reduce 6-month MACE in elderly patients with AMI and left ventricular dysfunction who underwent PCI?
Odds Ratio: 0.328 (95% CI 0.115–0.933)
Absolute Event Rate: 19.3% vs 34.1%
p-value: p=0.037
Statin therapy prescribed before discharge significantly reduces 6-month major adverse cardiac events and all-cause mortality in elderly patients with acute myocardial infarction and left ventricular dysfunction undergoing PCI.
May support pre-discharge statins in this elderly post-PCI subgroup; hypothesis-generating and requires RCTs before practice change.
The purpose of the present study was to assess the clinical effects of statin on major adverse cardiac events (MACE) at the time of discharge in elderly patients with acute myocardial infarction (AMI) and with left ventricular dysfunction (LVD) who underwent percutaneous coronary intervention (PCI). The study was retrospective. One hundred seventy-nine elderly patients (≥70 year-old) with AMI with LVD (ejection fraction≤50%) who underwent PCI were analyzed out of AMI patients between 2006 and 2008. The patients were divided into two groups: Group I (n=137, 77.0±5.3 years, 81 males), who received statin before discharge, and Group II (n=42, 78.3±5.9 years, 22 males), who did not receive any statin. We performed a 6-month clinical follow-up after discharge. There were no significant differences in age, sex ratio, history of ischemic heart disease, blood pressure, heart rate on admission, ejection fraction, or prevalence of diabetes, hypertension, or dyslipidemia. According to the multiple logistic regression analysis, age was an independent predictor (p=0.003) and statin use significantly reduced 6-month MACE (p=0.037, OR=0.328, 95% CI: 0.115∼0.933). No other factors were independent predictors of 6-month MACE. Statin therapy improves clinical outcomes in elderly AMI patients with LVD who undergo PCI.
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Park et al. (2010) conducted a cohort in Acute myocardial infarction with left ventricular dysfunction (n=179). Statin vs. No statin was evaluated on 6-month major adverse cardiac events (MACE) (OR 0.328, 95% CI 0.115-0.933, p=0.037). Statin therapy prescribed before discharge significantly reduced the odds of 6-month major adverse cardiac events (OR 0.328) in elderly patients with acute myocardial infarction and left ventricular dysfunction who underwent percutaneous coronary intervention.
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