Circulation Journal
Online ISSN : 1347-4820
Print ISSN : 1346-9843
ISSN-L : 1346-9843
Ischemic Heart Disease
Effects of Statin Intensity on Clinical Outcome in Acute Myocardial Infarction Patients
Doyeon HwangHyun Kuk KimJoo Myung LeeKi Hong ChoiJihoon KimTae-Min RheeJonghanne ParkTaek Kyu ParkJeong Hoon YangYoung Bin SongJin-Ho ChoiJoo-Yong HahnSeung-Hyuk ChoiBon-Kwon KooYoung Jo KimShung Chull ChaeMyeong Chan ChoChong Jin KimHyeon-Cheol GwonMyung Ho JeongHyo-Soo KimThe KAMIR Investigators
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2018 Volume 82 Issue 4 Pages 1112-1120

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Abstract

Background:There has been debate regarding the added benefit of high-intensity statins compared with low-moderate-intensity statins, especially in patients with acute myocardial infarction (AMI).

Methods and Results:The Korea Acute Myocardial Infarction Registry-National Institutes of Health consecutively enrolled 13,104 AMI patients. Of these, a total of 12,182 patients, who completed 1-year follow-up, were included in this study, and all patients were classified into 3 groups (no statin; low-moderate-intensity statin; and high-intensity statin). The primary outcome was major adverse cardiac event (MACE) including cardiac death, non-fatal MI, and repeat revascularization at 1 year. Both low-moderate-intensity and high-intensity statin significantly reduced low-density lipoprotein cholesterol (LDL-C; all P<0.001). Compared with the no statin group, both statin groups had significantly lower risk of MACE (low-moderate intensity: HR, 0.506; 95% CI: 0.413–0.619, P<0.001; high intensity: HR, 0.464; 95% CI: 0.352–0.611, P<0.001). The risk of MACE, however, was similar between the low-moderate- and high-intensity statin groups (HR, 0.917; 95% CI: 0.760–1.107, P=0.368). Multivariable adjustment, propensity score matching, and inverse probability weighted analysis also produced the same results.

Conclusions:When adequate LDL-C level is achieved, patients on a low-moderate-intensity statin dose have similar cardiovascular outcomes to those on high-intensity statins.

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© 2018 THE JAPANESE CIRCULATION SOCIETY
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