Abstract 14440: Statin Can Reduce Stent Thrombosis After Stent Implantation In Acute Myocardial Infarction Patients With High Level of Inflammatory Marker
Introduction: It has been reported that stent thrombosis (ST) is accelerated in acute inflammatory status and statin therapy can reduce thrombosis as a pleotrophic anti-inflammatory effect.
Hypothesis: This analysis from the Korean Acute Myocardial Registry (KAMIR) assessed the beneficial effect of statin therapy for stent thrombosis in acute myocardial infarction (AMI) patients according to level of high sensitivity C-reactive protein (hs-CRP).
Methods: 4861 AMI patients (mean age = 63.6 ± 12.7 years, 3436 males, 2853 ST elevation MI, 2008 non ST elevation MI) who underwent coronary stent implantation were divided into two groups; low level of hs-CRP group (hs-CRP < 2 mg/dl, n = 3100, 62.9 ± 11.4 years, 2204 males) or high level of hs-CRP group (hs-CRP ≥2mg/dl, n = 1761, 64.3 ± 12.1 years, 1232 males). We evaluated the incidence of stent thromobosis according to treatment with statin in each groups during in hospital period and one year clinical follow up.
Results: The baseline clinical characteristics were similar between the groups including hemodynamic parameters, killip class, risk factor of atherosclerosis, electrocardiographic and echographic and coronary angiographic findings. The more STs were developed in high level of hs-CRP group rather than low level of hs-CRP group [2.6% (46/1761) vs. 1.6% (50/3100), p=0.016, hazard ratio (HR): 1.64, 95% confidence interval (CI): 1.09-2.45]. Statin therapy did not affect the development of ST in low level of hs-CRP group [statin treatment subgroup: 1.4% (33/2307) vs. no statin treatment subgroup: 2.2% (17/789), p=0.164, HR: 0.659, 95% CI: 0.36-1.19]. However in high level of hs-CRP group, the incidence of ST was significantly decreased with statin treatment [statin treatment subgroup: 1.7% (21/1232), no statin treatment subgroup: 4.7% (25/529), p<0.001, HR: 0.35, 95% CI: 0.19-0.63].
Conclusion: Statin therapy can reduce the thrombotic reaction after stent implantation in AMI patients with high level of hs-CRP, associated with pleotrophic anti-inflammatory effect of the statin.
- © 2011 by American Heart Association, Inc.