Effect on short- and long-term major adverse cardiac events of statin treatment in patients with acute myocardial infarction and renal dysfunction
The American Journal of Cardiology, 05/04/2012
Lim SY et al. – Statin therapy reduced major adverse cardiac events (MACE) at 1 year of follow–up in patients with acute myocardial infarction (AMI) regardless of renal dysfunction (RD).Methods
- The 3–hydroxy–3–methylglutaryl–coenzyme A reductase inhibitors (statins) reduce major adverse cardiac events (MACE) and mortality in patients with acute coronary syndrome.
- Authors investigated the effectiveness of statin therapy in reducing MACE in patients with acute myocardial infarction (AMI) and renal dysfunction (RD).
- In the present retrospective study of 12,853 patients with AMI, the patients were categorized into 4 groups: group I, statin therapy and no RD (estimated glomerular filtration rate ≥60 ml/min/1.73 m2); group II, neither statin therapy nor RD; group III, statin therapy and RD; group IV, no statin therapy but RD.
- The primary end points were death and complications during the hospital course.
- The secondary end points were MACE during 1 year of follow–up after AMI.
- Significant differences in the composite MACE during 12 months of follow–up were observed among the 4 groups (group I, 11.7%; group II, 19.0%; group III, 26.7%; and group IV, 45.5%; p <0.001).
- In a Cox proportional hazards model, mortality at 12 months increased stepwise from group II to IV compared to group I.
- Moreover, MACE–free survival in the severe RD group (estimated glomerular filtration rate <30 mL/min/1.73 m2) was also greater in the statin–treated group.