Effect of chronic statin pretreatment on hospital outcome in patients with acute non-ST-elevation myocardial infarction.
OBJECTIVE
We sought to investigate the impact of prior statin therapy on in-hospital outcome in patients presenting with acute non-ST-elevation myocardial infarction.


RESULTS
We analyzed the data of consecutive patients with non-ST-elevation myocardial infarction who were prospectively enrolled in the German Acute Coronary Syndrome Registry between July 2000 and November 2002. Overall, 6358 patients were included, and we compared the patients who received statins before hospital admission (n = 1247, 19.6%) with those who did not (n = 5111, 80.4%). There was no age difference between the two groups; however, pretreated patients had a higher incidence of prior atherothrombotic events diabetes mellitus and renal insufficiency. The percentage of patients undergoing percutaneous coronary intervention and coronary artery bypass grafting was similar. Infarct size measured by peak creatine kinase level was lower in statin users (238 vs. 283 U/L, P < 0.0001). After adjustment for confounding variables, a significant reduction of in-hospital death could be observed in patients on statins (odds ratio 0.65, 95% confidence interval 0.46-0.90).


CONCLUSIONS
In clinical practice, pretreatment with statins was associated with smaller myocardial infarction size (peak creatine kinase level) and a significant reduction of hospital mortality. However, the data were obtained from an observational study, and the results need further prospective confirmation.
Bauer
Timm
T
Department of Cardiology, Herzzentrum Ludwigshafen, Ludwigshafen, Germany. bauer-timm@gmx.de
Böhm
Michael
M
Zahn
Ralf
R
Jünger
Claus
C
Koeth
Oliver
O
Gitt
Anselm
A
Bestehorn
Kurt
K
Senges
Jochen
J
Zeymer
Uwe
U
D000208:Acute Disease; D000368:Aged; D003402:Creatine Kinase / Q000097:blood; D005260:Female; D005858:Germany / Q000453:epidemiology; D017052:Hospital Mortality; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage* / Q000627:therapeutic use*; D015994:Incidence; D007297:Inpatients; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology; D011446:Prospective Studies; D012042:Registries; D016896:Treatment Outcome
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D003402:Creatine Kinase