title: Effect of previous statin therapy in patients with acute coronary syndrome and percutaneous coronary intervention.
abstract: OBJECTIVE
  Statin therapy after percutaneous coronary intervention (PCI) has been associated with reduced major adverse cardiovascular events (MACE). However, it has been less clear as to whether statin therapy before acute coronary syndrome (ACS) is beneficial. We studied the effect of previous statin therapy, initiated ≥1 month before PCI, on the outcome of patients with ACS who had undergone early invasive strategies.
  
  
  METHODS
  We stratified 479 consecutive patients with ACS who had undergone PCI, according to preprocedural statin administration as follows: previous statin-treated patients (statin group, n=237) and statin-naive patients (control group, n=242). The incidence of periprocedural myocardial infarction (MI) and in-hospital MACE was assessed.
  
  
  RESULTS
  The incidence of Braunwald class III angina and MI presentation were significantly lower in the statin group than in the control group. Angiographic and procedural characteristics were similar between the two groups; however, slow/no reflow phenomenon occurred more frequently in the control group. After PCI, the incidence of periprocedural MI was higher in the control group than in the statin group (6.6% vs. 2.1%, p=0.016). Multivariate analysis revealed that no prior use of statin {odds ratio (OR)=2.8; 95% confidence interval (CI)=1.1-7.2; p=0.038), procedural complication (OR=4.0; 95% CI=1.5-10.5; p=0.004), stent overlap (OR=4.7; 95% CI=1.3-16.4; p=0.015), and old age (OR=3.2; 95% CI=1.2-8.0; p=0.016) were independent predictors for in-hospital MACE.
  
  
  CONCLUSIONS
  Previous statin therapy before ACS was associated with milder clinical presentation and lower incidence of in-hospital MACE after early invasive strategies. The beneficial outcome is attributable to a significant reduction in periprocedural MI after PCI.
authors.affiliation: Department of Cardiovascular Medicine, Regional Cardiocerebrovascular Center, Wonkwang University Hospital, Iksan, Korea.
authors.forename: Kyeong Ho
authors.initials: KH
authors.lastname: Yun
authors.forename: Ik-Sang
authors.initials: IS
authors.lastname: Shin
authors.forename: Seoung-Nam
authors.initials: SN
authors.lastname: Shin
authors.forename: Jun-Ho
authors.initials: JH
authors.lastname: Choi
authors.forename: Seung Hwan
authors.initials: SH
authors.lastname: Kim
authors.forename: Sang Jae
authors.initials: SJ
authors.lastname: Rhee
authors.forename: Eun Mi
authors.initials: EM
authors.lastname: Lee
authors.forename: Nam Jin
authors.initials: NJ
authors.lastname: Yoo
authors.forename: Nam-Ho
authors.initials: NH
authors.lastname: Kim
authors.forename: Seok Kyu
authors.initials: SK
authors.lastname: Oh
authors.forename: Jin-Won
authors.initials: JW
authors.lastname: Jeong