Comparing High-Intensity Versus Low-to Moderate-Intensity Statin Therapy in Korean Patients with Acute Myocardial Infarction

Minah Kim; Hyun Kuk Kim; Youngkeun Ahn; Hyukjin Park; Myung Ho Jeong; Jeong Gwan Cho; Jong Chun Park; Young Jo Kim; Myeong Chan Cho; Chong Jin Kim

doi:10.12997/jla.2014.3.2.97

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Kim, Kim, Ahn, Park, Jeong, Cho, Park, Kim, Cho, Kim, and Korea Acute Myocardial Infarction Registry Investigators: Comparing High-Intensity Versus Low-to Moderate-Intensity Statin Therapy in Korean Patients with Acute Myocardial Infarction

Original Article

Journal of Lipid and Atherosclerosis 2014; 3(2): 97-104.

Published online: 31 December 2014

DOI: https://doi.org/10.12997/jla.2014.3.2.97

Comparing High-Intensity Versus Low-to Moderate-Intensity Statin Therapy in Korean Patients with Acute Myocardial Infarction

Minah Kim^1,^*, Hyun Kuk Kim^1,^*, Youngkeun Ahn¹, Hyukjin Park¹, Myung Ho Jeong¹, Jeong Gwan Cho¹, Jong Chun Park¹, Young Jo Kim², Myeong Chan Cho³, Chong Jin Kim⁴; Korea Acute Myocardial Infarction Registry Investigators

¹Department of Cardiology, Chonnam National University Hospital, Gwangju, Korea.

²Department of Cardiology, Yeungnam University Hospital, Daegu, Korea.

³Department of Cardiology, Chungbuk National University Hospital, Cheongu, Korea.

⁴Department of Cardiology, Kyunghee University Hospital, Seoul, Korea.

Corresponding Author: Youngkeun Ahn, Department of Cardiology, Cardiovascular Center, Chonnam National University Hospital, 671 Jebong-ro, Dong-gu, Gwangju 501-757, Korea. Tel: +82-62-220-4764, Fax: +82-62-224-4764, cecilyk@hanmail.net

Equal contributor:

*Both authors contributed equally to this work.

Received 5 December 2014 Revised 23 December 2014 Accepted 26 December 2014

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective

The aim of this study is to compare the clinical benefits between high-intensity and low-to moderate-intensity statin therapy in patients with acute myocardial infarction (AMI).

Methods

A total of 1,230 patients in the Korea AMI Registry (KAMIR) were enrolled. Patients were divided into two groups according to the dosage of statin for the secondary prevention after AMI.

The primary endpoint was composite of major adverse cardiac events (MACEs) including cardiac death, non-fatal MI, repeat revascularization during the 12 months of clinical follow-up.

Result

The primary endpoint occurred in 101 patients (11.3%) from the low-to moderate-intensity statin group and 45 patients (13.4%) from the high-intensity statin group. The cumulative incidence of MACEs during 12-month follow-up was not significantly different between the two groups (p=0.323). After multi-variate analysis, MACEs-free survival rate was not significantly different between the two groups.

Conclusion

High-intensity statin therapy did not show additional clinical benefit over low-to moderate-intensity statin therapy after AMI.

Keywords: Myocardial infarction, Statin, Secondary prevention

Figures and Tables

Fig. 1

Kaplan-Meier curve for 12-month major adverse cardiac event-free survival rates between low-intermediate intensity statin group and high intensity statin group.

Table 1

Baseline clinical characteristics at presentation

^*Values are presented as mean±standard deviation or number (%)

BMI; body mass index, CAD; coronary artery disease, IHD; ischemic heart disease, SBP; systolic blood pressure, DBP; diastolic blood pressure, HR; heart rate, LDL; low density lipoprotein, HDL; high density lipoprotein

Table 2

Angiographic and procedural characteristics

^*Values are presented as mean±standard deviation or number (%)

TIMI; Thrombolysis In Myocardial Infarction

Table 3

Medications at the time of discharge

ACE; angiotensin converting enzyme, ARB; aldosterone receptor blocker

Table 4

Changes of LDL-cholesterol level

LDL-C; low density lipoprotein cholesterol

Table 5

Cumulative incidences of MACEs during 12-month follow up

MACEs; major adverse cardiac events, CABG; coronary artery bypass graft, PCI; percutaneous coronary intervention, MI; myocardial infarction

Table 6

Factors which influenced occurrence of MACEs during 12-month follow up

MACEs; major adverse cardiac events, CI; confidence interval, IHD; ischemic heart disease

ACKNOWLEDGEMENTS

This study was supported by a grant of the National Research Foundation of Korea Grant funded by the Korean Government (MEST), Republic of Korea (2010-0020261), and the Korean Health Technology R&D Project, Ministry of Health & Welfare, Republic of Korea (HI12C0199, HI13C1527).

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