Abstract 15131: Beneficial Effects of Hydrophilic Statins on Prevention of Adverse Cardiac Events in Diabetic Patients after Acute Myocardial Infarction as Compared to Lipophilic Statins
Background: Many reports have revealed that statins have beneficial effects on cardiovascular diseases, and should be routinely prescribed for patients with acute myocardial infarction (AMI). Some animal experimental reports showed lipophilic statins deteriorated the myocardial contraction after reperfusion in dogs as compared to hydrophilic statins. Another reports suggested that hydrophilic statins increased serum adiponectin level and decreased plasma C-reactive protein level (hs-CRP) as compared to lipophilic statin. On the other hand, it has been reported that diabetic patients, who usually had poor prognosis after AMI, showed lower serum level of adiponectin and higher serum level of hs-CRP. Thus, in this study, we investigated which kind of statins, hydrophilic statin or lipophilic statin, can protect adverse cardiac events in diabetic or non-diabetic patients after AMI.
Methods: The present study group comprised 2926 patients, 1020 diabetic and 1906 non-diabetic patients, with AMI who received statins (hydrophilic statin (n=1363) and lipophilic statin (n=1563)). To evaluate the effect of each statin on protection of cardiac adverse events after AMI, multivariate-adjusted hazard ratios (adjusted HR) and 95% confidence interval (95% CI) were estimated by means of multivariate analyses with major adverse cardiac event (MACE) including cardiac death, heart failure and non-fatal re-infarction as dependent variable and age, baseline coronary risk factors including dyslipidemia, medications including renin-angiotensin system blocker and antiplatelet therapy and cardiac damage parameters including creatine phosphokinase value > 3000, history of old myocardial infarction and class of statin (hydro or lipophilic statin) as independent variables.
Conclusions: Hydrophilic statin, as compared to lipophilic statin, may have the beneficial protective effects against cardiovascular events in diabetic patients after AMI.
- © 2011 by American Heart Association, Inc.