Benefit of early statin therapy in patients with acute myocardial infarction who have extremely low low-density lipoprotein cholesterol

Ki Hong Lee, Myung Ho Jeong, Ha Mi Kim, Youngkeun Ahn, Jong Hyun Kim, Shung Chull Chae, Young Jo Kim, Seung Ho Hur, In Whan Seong, Taek Jong Hong, Dong Hoon Choi, Myeong Chan Cho, Chong Jin Kim, Ki Bae Seung, Wook Sung Chung, Yang Soo Jang, Seung Woon Rha, Jang Ho Bae, Jeong Gwan Cho, Seung Jung Park

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Abstract

Objectives: We investigated whether statin therapy could be beneficial in patients with acute myocardial infarction (AMI) who have baseline low-density lipoprotein cholesterol (LDL-C) levels below 70 mg/dl. Background: Intensive lipid-lowering therapy with a target LDL-C value <70 mg/dl is recommended in patients with very high cardiovascular risk. However, whether to use statin therapy in patients with baseline LDL-C levels below 70 mg/dl is controversial. Methods: We analyzed 1,054 patients with AMI who had baseline LDL-C levels below 70 mg/dl and survived at discharge from the Korean Acute MI Registry between November 2005 and December 2007. They were divided into 2 groups according to the prescribing of statins at discharge (statin group n = 607; nonstatin group n = 447). The primary endpoint was the composite of 1-year major adverse cardiac events, including death, recurrent MI, target vessel revascularization, and coronary artery bypass grafting. Results: Statin therapy significantly reduced the risk of the composite primary endpoint (adjusted hazard ratio [HR]: 0.56; 95% confidence interval [CI]: 0.34 to 0.89; p = 0.015). Statin therapy reduced the risk of cardiac death (HR: 0.47; 95% CI: 0.23 to 0.93; p = 0.031) and coronary revascularization (HR: 0.45, 95% CI: 0.24 to 0.85; p = 0.013). However, there were no differences in the risk of the composite of all-cause death, recurrent MI, and repeated percutaneous coronary intervention rate. Conclusions: Statin therapy in patients with AMI with LDL-C levels below 70 mg/dl was associated with improved clinical outcome.

Original languageEnglish
Pages (from-to)1664-1671
Number of pages8
JournalJournal of the American College of Cardiology
Volume58
Issue number16
DOIs
Publication statusPublished - 2011 Oct 11

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Secondary Prevention
LDL Cholesterol
Myocardial Infarction
Confidence Intervals
Therapeutics
Percutaneous Coronary Intervention
Coronary Artery Bypass
Registries
Cause of Death
Lipids

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Lee, Ki Hong ; Jeong, Myung Ho ; Kim, Ha Mi ; Ahn, Youngkeun ; Kim, Jong Hyun ; Chae, Shung Chull ; Kim, Young Jo ; Hur, Seung Ho ; Seong, In Whan ; Hong, Taek Jong ; Choi, Dong Hoon ; Cho, Myeong Chan ; Kim, Chong Jin ; Seung, Ki Bae ; Chung, Wook Sung ; Jang, Yang Soo ; Rha, Seung Woon ; Bae, Jang Ho ; Cho, Jeong Gwan ; Park, Seung Jung. / Benefit of early statin therapy in patients with acute myocardial infarction who have extremely low low-density lipoprotein cholesterol. In: Journal of the American College of Cardiology. 2011 ; Vol. 58, No. 16. pp. 1664-1671.
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title = "Benefit of early statin therapy in patients with acute myocardial infarction who have extremely low low-density lipoprotein cholesterol",
abstract = "Objectives: We investigated whether statin therapy could be beneficial in patients with acute myocardial infarction (AMI) who have baseline low-density lipoprotein cholesterol (LDL-C) levels below 70 mg/dl. Background: Intensive lipid-lowering therapy with a target LDL-C value <70 mg/dl is recommended in patients with very high cardiovascular risk. However, whether to use statin therapy in patients with baseline LDL-C levels below 70 mg/dl is controversial. Methods: We analyzed 1,054 patients with AMI who had baseline LDL-C levels below 70 mg/dl and survived at discharge from the Korean Acute MI Registry between November 2005 and December 2007. They were divided into 2 groups according to the prescribing of statins at discharge (statin group n = 607; nonstatin group n = 447). The primary endpoint was the composite of 1-year major adverse cardiac events, including death, recurrent MI, target vessel revascularization, and coronary artery bypass grafting. Results: Statin therapy significantly reduced the risk of the composite primary endpoint (adjusted hazard ratio [HR]: 0.56; 95{\%} confidence interval [CI]: 0.34 to 0.89; p = 0.015). Statin therapy reduced the risk of cardiac death (HR: 0.47; 95{\%} CI: 0.23 to 0.93; p = 0.031) and coronary revascularization (HR: 0.45, 95{\%} CI: 0.24 to 0.85; p = 0.013). However, there were no differences in the risk of the composite of all-cause death, recurrent MI, and repeated percutaneous coronary intervention rate. Conclusions: Statin therapy in patients with AMI with LDL-C levels below 70 mg/dl was associated with improved clinical outcome.",
author = "Lee, {Ki Hong} and Jeong, {Myung Ho} and Kim, {Ha Mi} and Youngkeun Ahn and Kim, {Jong Hyun} and Chae, {Shung Chull} and Kim, {Young Jo} and Hur, {Seung Ho} and Seong, {In Whan} and Hong, {Taek Jong} and Choi, {Dong Hoon} and Cho, {Myeong Chan} and Kim, {Chong Jin} and Seung, {Ki Bae} and Chung, {Wook Sung} and Jang, {Yang Soo} and Rha, {Seung Woon} and Bae, {Jang Ho} and Cho, {Jeong Gwan} and Park, {Seung Jung}",
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Lee, KH, Jeong, MH, Kim, HM, Ahn, Y, Kim, JH, Chae, SC, Kim, YJ, Hur, SH, Seong, IW, Hong, TJ, Choi, DH, Cho, MC, Kim, CJ, Seung, KB, Chung, WS, Jang, YS, Rha, SW, Bae, JH, Cho, JG & Park, SJ 2011, 'Benefit of early statin therapy in patients with acute myocardial infarction who have extremely low low-density lipoprotein cholesterol', Journal of the American College of Cardiology, vol. 58, no. 16, pp. 1664-1671. https://doi.org/10.1016/j.jacc.2011.05.057

Benefit of early statin therapy in patients with acute myocardial infarction who have extremely low low-density lipoprotein cholesterol. / Lee, Ki Hong; Jeong, Myung Ho; Kim, Ha Mi; Ahn, Youngkeun; Kim, Jong Hyun; Chae, Shung Chull; Kim, Young Jo; Hur, Seung Ho; Seong, In Whan; Hong, Taek Jong; Choi, Dong Hoon; Cho, Myeong Chan; Kim, Chong Jin; Seung, Ki Bae; Chung, Wook Sung; Jang, Yang Soo; Rha, Seung Woon; Bae, Jang Ho; Cho, Jeong Gwan; Park, Seung Jung.

In: Journal of the American College of Cardiology, Vol. 58, No. 16, 11.10.2011, p. 1664-1671.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Benefit of early statin therapy in patients with acute myocardial infarction who have extremely low low-density lipoprotein cholesterol

AU - Lee, Ki Hong

AU - Jeong, Myung Ho

AU - Kim, Ha Mi

AU - Ahn, Youngkeun

AU - Kim, Jong Hyun

AU - Chae, Shung Chull

AU - Kim, Young Jo

AU - Hur, Seung Ho

AU - Seong, In Whan

AU - Hong, Taek Jong

AU - Choi, Dong Hoon

AU - Cho, Myeong Chan

AU - Kim, Chong Jin

AU - Seung, Ki Bae

AU - Chung, Wook Sung

AU - Jang, Yang Soo

AU - Rha, Seung Woon

AU - Bae, Jang Ho

AU - Cho, Jeong Gwan

AU - Park, Seung Jung

PY - 2011/10/11

Y1 - 2011/10/11

N2 - Objectives: We investigated whether statin therapy could be beneficial in patients with acute myocardial infarction (AMI) who have baseline low-density lipoprotein cholesterol (LDL-C) levels below 70 mg/dl. Background: Intensive lipid-lowering therapy with a target LDL-C value <70 mg/dl is recommended in patients with very high cardiovascular risk. However, whether to use statin therapy in patients with baseline LDL-C levels below 70 mg/dl is controversial. Methods: We analyzed 1,054 patients with AMI who had baseline LDL-C levels below 70 mg/dl and survived at discharge from the Korean Acute MI Registry between November 2005 and December 2007. They were divided into 2 groups according to the prescribing of statins at discharge (statin group n = 607; nonstatin group n = 447). The primary endpoint was the composite of 1-year major adverse cardiac events, including death, recurrent MI, target vessel revascularization, and coronary artery bypass grafting. Results: Statin therapy significantly reduced the risk of the composite primary endpoint (adjusted hazard ratio [HR]: 0.56; 95% confidence interval [CI]: 0.34 to 0.89; p = 0.015). Statin therapy reduced the risk of cardiac death (HR: 0.47; 95% CI: 0.23 to 0.93; p = 0.031) and coronary revascularization (HR: 0.45, 95% CI: 0.24 to 0.85; p = 0.013). However, there were no differences in the risk of the composite of all-cause death, recurrent MI, and repeated percutaneous coronary intervention rate. Conclusions: Statin therapy in patients with AMI with LDL-C levels below 70 mg/dl was associated with improved clinical outcome.

AB - Objectives: We investigated whether statin therapy could be beneficial in patients with acute myocardial infarction (AMI) who have baseline low-density lipoprotein cholesterol (LDL-C) levels below 70 mg/dl. Background: Intensive lipid-lowering therapy with a target LDL-C value <70 mg/dl is recommended in patients with very high cardiovascular risk. However, whether to use statin therapy in patients with baseline LDL-C levels below 70 mg/dl is controversial. Methods: We analyzed 1,054 patients with AMI who had baseline LDL-C levels below 70 mg/dl and survived at discharge from the Korean Acute MI Registry between November 2005 and December 2007. They were divided into 2 groups according to the prescribing of statins at discharge (statin group n = 607; nonstatin group n = 447). The primary endpoint was the composite of 1-year major adverse cardiac events, including death, recurrent MI, target vessel revascularization, and coronary artery bypass grafting. Results: Statin therapy significantly reduced the risk of the composite primary endpoint (adjusted hazard ratio [HR]: 0.56; 95% confidence interval [CI]: 0.34 to 0.89; p = 0.015). Statin therapy reduced the risk of cardiac death (HR: 0.47; 95% CI: 0.23 to 0.93; p = 0.031) and coronary revascularization (HR: 0.45, 95% CI: 0.24 to 0.85; p = 0.013). However, there were no differences in the risk of the composite of all-cause death, recurrent MI, and repeated percutaneous coronary intervention rate. Conclusions: Statin therapy in patients with AMI with LDL-C levels below 70 mg/dl was associated with improved clinical outcome.

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