Key result
Early statins within 48 hours of AMI linked to ~33% lower one-year MACE risk.
Why the study?
The effectiveness of early statin therapy within 48 hours after admission in reducing major adverse cardiac events in patients with acute myocardial infarction was investigated.
Does statin therapy initiated within 48 hours after admission reduce major adverse cardiac events at one year in patients with acute myocardial infarction?
Cohort (n=1,159)
No
Does statin therapy initiated within 48 hours after admission reduce major adverse cardiac events at one year in patients with acute myocardial infarction?
Odds Ratio: 1.49 (95% CI 1–2.21)
Absolute Event Rate: 17.8% vs 24.6%
p-value: p=0.045
Initiating statin therapy within 48 hours of admission for acute myocardial infarction is associated with a significant reduction in one-year major adverse cardiac events.
Early statin initiation within 48 hours was associated with lower one-year MACE in AMI; leaves open whether randomized trials would confirm benefit.
HMG-CoA reductase inhibitors (statins) reduce major adverse cardiac events (MACE) and mortality in patients with acute coronary syndrome. We investigated whether early statin therapy would be effective at reducing MACE in patients with acute myocardial infarction (AMI).A total of 1,159 patients were analyzed. They were grouped by initiation time of statin administration after admission as follows: group I; n = 945, ≤ 48 hours, group II; n = 214, > 48 hours.Cardiovascular risk factors and noncardiac comorbidities were not different between the two groups. ST-elevation MI as initial diagnosis was more prevalent in group I (68.4% versus 59.3%, P = 0.013). In-hospital mortality was not different in the two groups (0.8% versus 0.5%, P = 0.483). In one-year clinical follow-up, MACE and repercutaneous coronary intervention were lower in group I (17.8% versus 24.6%, P = 0.016, 10.2% versus 15.5%, P = 0.021, respectively). However, there was no difference in mortality (3.8% versus 4.7%, P = 0.319). In multivariate analysis, statin initiation within 48 hours after admission was an independent predictor of one-year MACE (OR 1.49, 95% CI = 1.00-2.21, P = 0.045).Consequently, early statin therapy within 48 hours after admission reduced MACE at one-year follow-up in patients with AMI.
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Kim et al. (2011) conducted a cohort in Acute Myocardial Infarction (n=1,159). Early statin therapy (≤ 48 hours after admission) vs. Late statin therapy (> 48 hours after admission) was evaluated on One-year Major Adverse Cardiac Events (MACE) (OR 1.49, 95% CI 1.00-2.21, p=0.045). Early statin therapy within 48 hours of admission reduced one-year major adverse cardiac events compared to late initiation in patients with acute myocardial infarction (17.8% vs 24.6%).
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