Key result
Prior statin use in ACS is linked to ~30% lower odds of presenting with STEMI.
Why the study?
Statin therapy stabilizes coronary plaque and may influence presentation patterns among patients with acute coronary syndromes, but the association with ACS presentation types was unclear.
Does prior use of statins reduce the probability of presenting with STEMI or AMI in patients with acute coronary syndromes?
Observational (n=1,322)
Does prior use of statins reduce the probability of presenting with STEMI or AMI in patients with acute coronary syndromes?
Prior statin use in patients presenting with acute coronary syndromes is associated with a less severe clinical presentation, favoring unstable angina over myocardial infarction.
Answers are grounded in this paper and cite their sources.
May lessen severe ACS presentations; hypothesis-generating observational data that leaves open causal effects and practice change.
Statin therapy stabilizes coronary plaque, and it could be associated with less ST elevation myocardial infarction (STEMI) and acute myocardial infarction (AMI) [which includes, STEMI + non-STEMI (NSTEMI)], among patients presenting acute coronary syndromes (ACS). The aim of this study was to determine any association between prior use of statins and presentation patterns in 1,322 ACS patients admitted between 2014 and 2016: STEMI [247], NSTEMI [461] or unstable angina (UA) [614]. Coronary risk factors, history and chronic use of statins, aspirin and beta blockers were collected. Uni, multivariable and propensity score analysis were performed. About half (46%) of the patients received statins but only 14% high doses. UA patients received more statins and higher doses =335 (54%)/117 (19%) compared to NSTEMI =189 (40%)/49 (11%), and STEMI =77 (31%)/21 (9%), P<0.0001. Statin use was independently associated with a lower probability of STEMI [ vs. NSTEMI/UA, odds ratio (OR) =0.70, 95% CI: 0.50–0.97, P=0.03] or AMI ( vs. UA, OR=0.66, 95% CI: 0.51–0.84, P<0.01). Results were confirmed by propensity score analysis (OR=0.739, 95% CI: 0.588–0.922, P<0.01). Pretreatment with statins in ACSs was more associated with UA than with myocardial infarction. This could be a way of coronary atherosclerotic plaque’s stabilization.
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Trivi et al. (2017) conducted an observational in Acute coronary syndromes (n=1,322). Prior use of statins vs. No prior use of statins was evaluated on Probability of STEMI (vs. NSTEMI/UA) (OR 0.70, 95% CI 0.50-0.97, p=0.03). Prior statin use in patients with acute coronary syndromes was associated with a lower probability of presenting with STEMI compared to NSTEMI or unstable angina.
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