title: Effects of early statin treatment on symptomatic heart failure and ischemic events after acute myocardial infarction in Japanese.
abstract: Statins have been shown to prevent coronary artery disease and to preserve left ventricular function in dilated cardiomyopathy. We hypothesized that early use of statins would decrease cardiovascular events, including heart failure in patients with acute myocardial infarction (AMI). To examine the effect of statins in Japanese patients with AMI, a prospective, randomized, open-label trial was conducted in 486 patients with normal total cholesterol levels. Patients were randomly assigned to receive any available statin (n = 241) within 96 hours of AMI onset or no statin (n = 245) and were followed for up to 24 months. The primary end point was a composite of cardiovascular death, nonfatal AMI, recurrent symptomatic myocardial ischemia, congestive heart failure, and stroke. Event rate for the primary end point was lower in the statin group than in the nonstatin group (6.1% vs 11.4%, p = 0.0433). The statin group had a lower risk of congestive heart failure and symptomatic myocardial ischemia (p = 0.0154 and 0.0264, respectively). In conclusion, early lipid-lowering therapy with statins decreases recurrent cardiovascular events, in particular, congestive heart failure.
authors.affiliation: Department of Cardiovascular Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan. tom@kumamoto-u.ac.jp
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Sakamoto
authors.forename: Sunao
authors.initials: S
authors.lastname: Kojima
authors.forename: Hisao
authors.initials: H
authors.lastname: Ogawa
authors.forename: Hideki
authors.initials: H
authors.lastname: Shimomura
authors.forename: Kazuo
authors.initials: K
authors.lastname: Kimura
authors.forename: Yasuhiro
authors.initials: Y
authors.lastname: Ogata
authors.forename: Naritsugu
authors.initials: N
authors.lastname: Sakaino
authors.forename: Akira
authors.initials: A
authors.lastname: Kitagawa
mesh_terms: D000368:Aged; D000789:Angina, Unstable / Q000453:epidemiology / Q000517:prevention & control*; D015906:Angioplasty, Balloon, Coronary; D044466:Asian People; D002097:C-Reactive Protein / Q000032:analysis; D002784:Cholesterol / Q000097:blood; D005260:Female; D005500:Follow-Up Studies; D006333:Heart Failure / Q000453:epidemiology / Q000517:prevention & control*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D010359:Patient Readmission; D011446:Prospective Studies; D015912:Thrombolytic Therapy; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002097:C-Reactive Protein; D002784:Cholesterol