Long-Term Clinical Outcomes of Statin Therapy Post-PCI in Absence of Dyslipidemia
A positive relationship was found between statin use and MACE-free survival after AMI regardless of the presence or absence of dyslipidemia.
Patients with or without dyslipidemia on long-term statin therapy after a percutaneous coronary intervention (PCI) for acute myocardial infarction (AMI) showed significantly lower incidences of major adverse cardiac events (MACE), cardiac death, and all-cause death compared with similar patients who did not take statins, according to study results published in Catheterization & Cardiovascular Interventions.
For this nonrandomized, multicenter, observational, retrospective study, investigators examined the 2-year clinical outcomes of statin therapy for Korean patients with AMI after PCI with 2nd generation drug-eluting stents (DES).
The researchers used data on 18,137 eligible patients enrolled in the Korea AMI Registry. Patients were divided into 4 groups: group A (n=309) with dyslipidemia/no statins, group B (n=2094) with dyslipidemia/yes statins, group C (n=672) without dyslipidemia/no statins, and group D (n=15,062) without dyslipidemia/yes statins.
The primary study outcomes were MACE, defined as recurrent nonfatal myocardial infarction, revascularization, and all-cause death.
The collective incidence of MACE during the 2 years of follow-up was higher in group A than group B and group D (adjusted hazard ratio [HR], 2.027; 95% confidence interval [CI], 1.098-3.743; P =.024; and HR, 2.110; 95% CI, 1.240-3.593, P =.006, respectively).
This significant difference was due to a higher collective incidence of cardiac death and all-cause death, but not of revascularization or myocardial infarction, for which the differences were not significant between the 4 groups.
There were several limitations to the study, including (1) it used real-world data, so the study was not randomized, (2) the presence of dyslipidemia was determined based on lab results and patient statements, without knowing if patients previously underwent successful lipid-lowering therapy, and (3) group A represented only 1.7% of the total study participants and had much poorer baseline profiles than the other groups.
Study investigators concluded that "statin therapy demonstrated significantly reduced incidences of MACE, all-cause death and [cardiac death] compared with statin non-users after PCI in AMI patients with or without dyslipidemia during 2-year follow-up period in the era of new-generation DES."
Kim YH, Her AY, Jeong MH, et al. Two-year outcomes of statin therapy in patients with acute myocardial infarction with or without dyslipidemia after percutaneous coronary intervention in the era of new-generation drug-eluting stents within Korean population: data from the Korea Acute Myocardial Infarction Registry [published online November 25, 2018]. Catheter Cardiovasc Interv. doi: 10.1002/ccd.27985