Beneficial effects of statins after percutaneous coronary intervention.
BACKGROUND
Evidence about the efficacy of statin treatment among patients after percutaneous coronary intervention (PCI) is very limited. The rapid advancement in PCI technology and near universal use of adjunctive cardioprotective medications make it necessary to formally assess the effect of statin therapy on cardiac events after PCI.


METHODS
This was a multicenter prospective cohort study.


METHODS
Patients who received stent implantation and survived to hospital discharge from the National Heart, Lung, and Blood Institute Dynamic Registry from 2004 to 2006 formed the study cohort. Patients with cardiogenic shock, in-hospital adverse events [including myocardial infarction and coronary artery bypass graft surgery (CABG)], liver disease, renal disease, alcoholism, or drug abuse were excluded. The occurrences of death, CABG, and repeat PCI, and repeat revascularization were collected over 1-year follow-up.


RESULTS
Of the 3227 patients evaluated, 2737 (85%) were prescribed a statin at discharge. By 1-year follow-up, incident events were 98 deaths, 44 CABG, 290 repeat PCI procedures, and 328 repeat revascularizations. After propensity score adjustment, postdischarge statin therapy was associated with lower risks of death [hazard ratio (HR): 0.58, 95% confidence interval (CI): 0.36-0.93, P = 0.02], CABG (HR: 0.49, 95% CI: 0.24-1.00, P = 0.05), and repeat revascularization (HR: 0.74, 95% CI: 0.56-1.00, P = 0.05).


CONCLUSIONS
These results support the routine use of statin therapy after PCI.
Department of Epidemiology, School of Public Health, Shanghai Jiao Tong University, Shanghai, China. zhz232@gmail.com
Zhi-Jiang
ZJ
Zhang
Oscar C
OC
Marroquin
Joel L
JL
Weissfeld
Roslyn A
RA
Stone
Suresh R
SR
Mulukutla
David O
DO
Williams
Faith
F
Selzer
Kevin E
KE
Kip
D000368:Aged; D016009:Chi-Square Distribution; D003131:Combined Modality Therapy; D003327:Coronary Disease / Q000628:therapy*; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D016014:Linear Models; D008297:Male; D008875:Middle Aged; D009656:North America; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012042:Registries; D015607:Stents; D015996:Survival Rate
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors