title: Benefit of early statin therapy in patients with acute myocardial infarction who have extremely low low-density lipoprotein cholesterol.
abstract: OBJECTIVE
  We investigated whether statin therapy could be beneficial in patients with acute myocardial infarction (AMI) who have baseline low-density lipoprotein cholesterol (LDL-C) levels below 70 mg/dl.
  
  
  BACKGROUND
  Intensive lipid-lowering therapy with a target LDL-C value <70 mg/dl is recommended in patients with very high cardiovascular risk. However, whether to use statin therapy in patients with baseline LDL-C levels below 70 mg/dl is controversial.
  
  
  METHODS
  We analyzed 1,054 patients with AMI who had baseline LDL-C levels below 70 mg/dl and survived at discharge from the Korean Acute MI Registry between November 2005 and December 2007. They were divided into 2 groups according to the prescribing of statins at discharge (statin group n = 607; nonstatin group n = 447). The primary endpoint was the composite of 1-year major adverse cardiac events, including death, recurrent MI, target vessel revascularization, and coronary artery bypass grafting.
  
  
  RESULTS
  Statin therapy significantly reduced the risk of the composite primary endpoint (adjusted hazard ratio [HR]: 0.56; 95% confidence interval [CI]: 0.34 to 0.89; p = 0.015). Statin therapy reduced the risk of cardiac death (HR: 0.47; 95% CI: 0.23 to 0.93; p = 0.031) and coronary revascularization (HR: 0.45, 95% CI: 0.24 to 0.85; p = 0.013). However, there were no differences in the risk of the composite of all-cause death, recurrent MI, and repeated percutaneous coronary intervention rate.
  
  
  CONCLUSIONS
  Statin therapy in patients with AMI with LDL-C levels below 70 mg/dl was associated with improved clinical outcome.
authors: Heart Research Center, Chonnam National UniversityHospital, 671 Jaebongro, Dong-gu, Gwangju, South Korea.
authors: Ki Hong
authors: KH
authors: Lee
authors: Myung Ho
authors: MH
authors: Jeong
authors: Ha Mi
authors: HM
authors: Kim
authors: Youngkeun
authors: Y
authors: Ahn
authors: Jong Hyun
authors: JH
authors: Kim
authors: Shung Chull
authors: SC
authors: Chae
authors: Young Jo
authors: YJ
authors: Kim
authors: Seung Ho
authors: SH
authors: Hur
authors: In Whan
authors: IW
authors: Seong
authors: Taek Jong
authors: TJ
authors: Hong
authors: Dong Hoon
authors: DH
authors: Choi
authors: Myeong Chan
authors: MC
authors: Cho
authors: Chong Jin
authors: CJ
authors: Kim
authors: Ki Bae
authors: KB
authors: Seung
authors: Wook Sung
authors: WS
authors: Chung
authors: Yang Soo
authors: YS
authors: Jang
authors: Seung Woon
authors: SW
authors: Rha
authors: Jang Ho
authors: JH
authors: Bae
authors: Jeong Gwan
authors: JG
authors: Cho
authors: Seung Jung
authors: SJ
authors: Park
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D008078:Cholesterol, LDL / Q000097:blood*; D004562:Electrocardiography / Q000379:methods; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D007723:Korea; D008055:Lipids / Q000737:chemistry; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy*; D009204:Myocardial Revascularization; D011446:Prospective Studies; D012042:Registries; D012306:Risk; D016896:Treatment Outcome
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids