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Different Statin Effects of ST-elevation Versus Non-ST-Elevation Acute Myocardial Infarction After Stent Implantation

Authors
 Yong Hoon Kim  ;  Ae-Young Her  ;  Myung Ho Jeong  ;  Byeong-Keuk Kim  ;  Sung-Jin Hong  ;  Seunghwan Kim  ;  Chul-Min Ahn  ;  Jung-Sun Kim  ;  Young-Guk Ko  ;  Donghoon Choi  ;  Myeong-Ki Hong  ;  Yangsoo Jang 
Citation
 AMERICAN JOURNAL OF THE MEDICAL SCIENCES, Vol.359(3) : 156-167, 2020-03 
Journal Title
AMERICAN JOURNAL OF THE MEDICAL SCIENCES
ISSN
 0002-9629 
Issue Date
2020-03
MeSH
Aged ; Drug-Eluting Stents / statistics & numerical data* ; Humans ; Middle Aged ; Non-ST Elevated Myocardial Infarction / epidemiology* ; Non-ST Elevated Myocardial Infarction / etiology ; Non-ST Elevated Myocardial Infarction / mortality ; Percutaneous Coronary Intervention / statistics & numerical data* ; Republic of Korea / epidemiology ; ST Elevation Myocardial Infarction / epidemiology* ; ST Elevation Myocardial Infarction / etiology ; ST Elevation Myocardial Infarction / mortality
Keywords
Cardiovascular outcomes ; Non-ST-segment elevation myocardial infarction ; Statins ; ST-segment elevation myocardial
Abstract
Background: Intensive statin therapy reduces cardiovascular events in acute coronary syndrome. The data concerning the long-term clinical impacts of statin therapy between ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) after drug-eluting stent implantation are limited. We compared the 2-year clinical outcomes between these 2 groups after statin therapy. Materials and Methods: A total of 30,616 Korean patients with acute myocardial infarction (AMI) were enrolled. Among them, 13,686 patients were classified as group A (STEMI statin user), 3,824 patients were as group B (STEMI statin nonuser), 10,398 patients were as group C (NSTEMI statin user), and 2,708 patients were as group D (NSTEMI statin nonuser). The major clinical endpoint was the occurrence of major adverse cardiac events (MACE) defined as all-cause death, recurrent myocardial infarction (re-MI), and any repeat revascularization during a 2-year follow-up period. Results: After adjustment, the cumulative risks of MACE (adjusted hazard ratio [aHR] = 1.112 [1.002-1.235]; P = 0.047), all-cause death (aHR = 1.271 [1.054-1.532]; P = 0.012), and target vessel revascularization (TVR, aHR = 1.262 [1.049-1.518]; P = 0.014) in group C were significantly higher than group A. The cumulative risks of MACE, all-cause death, and cardiac death of the statin nonuser group (groups B and D) were significantly higher compared with statin user group (groups A and C). Conclusions: Statin therapy was more effective in reducing the cumulative risks of MACE, all-cause death, and TVR in the STEMI group than NSTEMI group in Korean patients with AMI after successful drug-eluting stent implantation.
Full Text
https://www.clinicalkey.com/#!/content/playContent/1-s2.0-S0002962919304288
DOI
10.1016/j.amjms.2019.12.004
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Ko, Young Guk(고영국) ORCID logo https://orcid.org/0000-0001-7748-5788
Kim, Byeong Keuk(김병극) ORCID logo https://orcid.org/0000-0003-2493-066X
Kim, Jung Sun(김중선) ORCID logo https://orcid.org/0000-0003-2263-3274
Ahn, Chul-Min(안철민) ORCID logo https://orcid.org/0000-0002-7071-4370
Jang, Yang Soo(장양수) ORCID logo https://orcid.org/0000-0002-2169-3112
Choi, Dong Hoon(최동훈) ORCID logo https://orcid.org/0000-0002-2009-9760
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
Hong, Sung Jin(홍성진) ORCID logo https://orcid.org/0000-0003-4893-039X
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/190201
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