Abstract 16041: Beneficial Effects of Chronic Statin Pretreatment on Long-Term Prognosis in Patients With Acute Myocardial Infarction
Introduction: Chronic administration of statins before onset of acute myocardial infarction (AMI) has protective effects on coronary microcirculation and reduces the infarct size irrespective of presence of dyslipidemia. It is not well elucidated whether the beneficial effects of statin pretreatment would be persistent on the chronic stage of infarction.
Hypothesis: The protective effect of pretreatment of statin could be associated with the improvement of long-term prognosis after AMI.
Methods: Among consecutive 803 patients with AMI who admitted between April 2004 and September 2012, we followed up 746 patients (age: 64±13 years, male: 82.4%) whose clinical history including medication before administration was confirmed. The primary endpoint was all-cause death.
Results: Statins were administered in 112 patients (15.0%) before hospital administration for AMI. Patients with pretreatment of statins had significantly lower peak CK (2248±2008 vs. 3400±3663 IU/L, p=0.001) and CK-MB (153±126 vs. 245±390 IU/L, p=0.001) than those without it. The median of the follow-up period was 1026 days (range: 2 - 2024 days), and we observed all-cause death in 62 patients (8.3%) during that period. Kaplan-Meier survival curve analysis demonstrated that statin pretreatment was associated with better survival rate over the follow-up period (p= 0.018 by logrank test) (Figure). Patients receiving statin pretreatment had lower mortality among those with dyslipidemia (n=429, p=0.008), and tended to have it among those receiving statins at hospital discharge (n=396, p= 0.053).
Conclusions: Chronic pretreatment of statins before AMI onset was associated not only with smaller infarct size but also with better long-term survival.
Author Disclosures: K. Iwakura: Honoraria; Modest; Daiichi Sankyou, Mochida Pharmaceutical, AstraZeneca, MSD, Astellas Pharma, Tanabe Mitsubishi, Bristol-Mayers Squibb, Novartis. Consultant/Advisory Board; Modest; Nippon Boehringer Ingelheim. Honoraria; Significant; modest. Consultant/Advisory Board; Significant; modest. A. Okamura: None. Y. Koyama: None. M. Date: None. K. Inoue: None. H. Nagai: None. Y. Toyoshima: None. K. Tanaka: None. T. Oka: None. N. Tanaka: None. Y. Yamanaka: None. T. Yamasaki: None. T. Okada: None. Y. Sotomi: None. K. Azuma: None. Y. Orihara: None. S. Kameda: None. M. Iwamoto: None. Y. Ohta: None. K. Fujii: None.
- © 2014 by American Heart Association, Inc.