Preventive Statin Initiation Reduces STEMI Risk as Initial Manifestation of CVD

Early PCI of Concurrent CTO After STEMI
Early PCI of Concurrent CTO After STEMI
This study sought to determine whether statin initiation for the primary prevention of CVD would improve outcomes.

Preventive statin therapy reduced the risk of acute heart failure and myocardial infarction as clinical manifestations of cardiovascular disease, according to a study presented during the American College of Cardiology Annual Meeting, held virtually from May 15 to 17, 2021.

Investigators of this study sought to determine whether initiation of statin therapy for the primary prevention of cardiovascular disease has an effect on other cardiovascular outcomes across age, gender, and risk factors.

The study included data from 14,542 patients (aged ≥40 years) with acute coronary syndrome as the first manifestation of cardiovascular disease reported in the International Survey of Acute Coronary Syndromes (ISACS) Archives network of registries ( Identifier: NCT04008173) from 2010 2019.

Study outcomes included risk for ST-elevation myocardial infarction (STEMI), acute heart failure, and all-cause 30-day mortality associated with patients initiating preventative statin therapy for cardiovascular disease.

Among the study cohort, 12.5% of patients reported using statin therapy. The mean estimated 10-year risk of developing atherosclerotic cardiovascular disease was 25.8% (standard deviation [SD], 17.9) among those receiving statins vs 22.5% (SD, 17.1) among the nonusers. The risk of STEMI, however, was significantly lower among statin users vs nonusers (relative risk [RR] ratio, 0.64; 95% CI, 0.58-0.71).

When comparing the effect of statin use on STEMI risk by gender, the absolute reduction of risk was substantially greater among the men (absolute reduction, 11.5%; RR ratio, 0.61; 95% CI, 0.54-0.69) compared with women (absolute reduction 6.3%; RR ratio, 0.76; 95% CI, 0.64-0.90; P =.02).

Risk reduction of STEMI associated with statin therapy also translated to a reduction in hospitalizations for acute heart failure in both women (RR ratio, 0.66; 95% CI, 0.53-0.83) and men (RR ratio, 0.74; 95% CI, 0.62-0.89; P =.22).

An estimated 10-year risk of developing cardiovascular disease lower than 10% had no effect on rates of STEMI or acute heart failure in either men or women. Only acute heart failure was predictive of 30-day mortality.

The investigators concluded that preventive statin therapy is effective in reducing the risks of STEMI and acute heart failure as initial manifestations of cardiovascular disease. This effect is most pronounced in men with a 10-year cardiovascular risk of at least 10%.


Cenko E, Bergami M, Yoon J, et al. Statins and severity of clinical manifestations among women and men with incident coronary heart disease. Presented at: American College of Cardiology (ACC) 2021 Annual Meeting; May 15-17, 2021. Abstract.