Effect of chronic statin pretreatment on hospital outcome in patients with acute non-ST-elevation myocardial infarction.

Abstract

PURPOSE:

We sought to investigate the impact of prior statin therapy on in-hospital outcome in patients presenting with acute non-ST-elevation myocardial infarction.

METHODS AND RESULTS:

We analyzed the data of consecutive patients with non-ST-elevation myocardial infarction who were prospectively enrolled in the German Acute Coronary Syndrome Registry between July 2000 and November 2002. Overall, 6358 patients were included, and we compared the patients who received statins before hospital admission (n = 1247, 19.6%) with those who did not (n = 5111, 80.4%). There was no age difference between the two groups; however, pretreated patients had a higher incidence of prior atherothrombotic events diabetes mellitus and renal insufficiency. The percentage of patients undergoing percutaneous coronary intervention and coronary artery bypass grafting was similar. Infarct size measured by peak creatine kinase level was lower in statin users (238 vs. 283 U/L, P < 0.0001). After adjustment for confounding variables, a significant reduction of in-hospital death could be observed in patients on statins (odds ratio 0.65, 95% confidence interval 0.46-0.90).

CONCLUSIONS:

In clinical practice, pretreatment with statins was associated with smaller myocardial infarction size (peak creatine kinase level) and a significant reduction of hospital mortality. However, the data were obtained from an observational study, and the results need further prospective confirmation.

• Authors: Timm Bauer, Michael Böhm, Ralf Zahn, Claus Jünger, Oliver Koeth, Anselm Gitt, Kurt Bestehorn, Jochen Senges, Uwe Zeymer, Acute Coronary Syndromes Registry Investigators
• Journal: Journal of cardiovascular pharmacology (J Cardiovasc Pharmacol) Vol. 53 Issue 2 Pg. 132-6 (Feb 2009) ISSN: 1533-4023 [Electronic] United States
• PMID: 19188836 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Creatine Kinase

Topics

• Acute Disease
• Aged
• Creatine Kinase (blood)
• Female
• Germany (epidemiology)
• Hospital Mortality
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (administration & dosage, therapeutic use)
• Incidence
• Inpatients
• Male
• Myocardial Infarction (drug therapy, mortality, pathology)
• Prospective Studies
• Registries
• Treatment Outcome