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Statin therapy and mortalitiy in patients with ST-segment elevation myocardial infarction treated with primary
Insights
Statin therapy significantly reduced one-year mortality in patients undergoing primary angioplasty for ST-segment elevation myocardial infarction (STEMI). These findings strongly support the use of statins post-STEMI for improved survival outcomes.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Statin therapy is known to reduce long-term mortality in coronary artery disease patients.
- The benefit of statins after primary angioplasty for ST-segment elevation myocardial infarction (STEMI) was not previously established.
Purpose of the Study:
- To determine if statin therapy is associated with reduced mortality in STEMI patients treated with primary angioplasty.
Main Methods:
- A total of 1513 STEMI patients treated with primary angioplasty were analyzed.
- Patients were divided into statin (n=893) and control (n=620) groups at discharge.
- One-year follow-up and multivariate analysis with propensity score were performed.
Main Results:
- Statin therapy was linked to significantly lower one-year mortality (1.2% vs. 7.1%, p<0.0001).
- Multivariate analysis confirmed statin use significantly reduced mortality (adjusted RR 0.24 [0.12-0.47], p<0.0001).
Conclusions:
- Statin therapy at discharge significantly reduces one-year mortality after primary angioplasty for STEMI.
- The study strongly recommends the use of statins in STEMI patients post-primary angioplasty.
Background:
Statin therapy can reduce long-term mortality in several subgroups of patients with coronary artery disease, but the benefits after primary angioplasty for ST-segment elevation myocardial infarction (STEMI) have yet to be established. Thus the aim of the current study was to determine whether statin therapy is associated with a reduction in mortality in patients with STEMI treated with primary angioplasty.
Methods:
Our population is represented by a total of 1513 consecutive in-hospital survivors treated with primary angioplasty for STEMI between April 1997 and October 2001. Patients were divided into two groups according to statin therapy (statin group, n=893; control group, n=620) at discharge. Clinical follow-up was performed at one year. Multivariate analysis was performed including a propensity score for statin use.
Results:
At one-year follow-up statin therapy was associated with a significantly lower mortality (1.2 vs. 71.%, RR [95% CI] 0.16 [0.09-0.32], p<0.0001). Also at multivariate analysis, including the propensity score, statin therapy was associated with a significant mortality reduction (adjusted RR [95% CI] 0.24 [0.12-0.47], p<0.0001).
Conclusion:
Statin therapy at discharge was associated with a significant reduction in one-year mortality after primary angioplasty for STEMI. Therefore, the use of statins after STEMI is highly recommended.
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