title: Effect on short- and long-term major adverse cardiac events of statin treatment in patients with acute myocardial infarction and renal dysfunction.
abstract: The 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) reduce major adverse cardiac events (MACE) and mortality in patients with acute coronary syndrome. We investigated the effectiveness of statin therapy in reducing MACE in patients with acute myocardial infarction (AMI) and renal dysfunction (RD). In the present retrospective study of 12,853 patients with AMI, the patients were categorized into 4 groups: group I, statin therapy and no RD (estimated glomerular filtration rate ≥60 ml/min/1.73 m(2)); group II, neither statin therapy nor RD; group III, statin therapy and RD; group IV, no statin therapy but RD. The primary end points were death and complications during the hospital course. The secondary end points were MACE during 1 year of follow-up after AMI. Significant differences in the composite MACE during 12 months of follow-up were observed among the 4 groups (group I, 11.7%; group II, 19.0%; group III, 26.7%; and group IV, 45.5%; p <0.001). In a Cox proportional hazards model, mortality at 12 months increased stepwise from group II to IV compared to group I. Moreover, MACE-free survival in the severe RD group (estimated glomerular filtration rate <30 mL/min/1.73 m(2)) was also greater in the statin-treated group. In conclusion, statin therapy reduced MACE at 1 year of follow-up in patients with AMI regardless of RD.
authors.affiliation: Department of Internal Medicine, Korea University, Ansan, Korea.
authors.forename: Sang Yup
authors.initials: SY
authors.lastname: Lim
authors.forename: Eun Hui
authors.initials: EH
authors.lastname: Bae
authors.forename: Joon Seok
authors.initials: JS
authors.lastname: Choi
authors.forename: Chang Seong
authors.initials: CS
authors.lastname: Kim
authors.forename: Jeong Woo
authors.initials: JW
authors.lastname: Park
authors.forename: Seong Kwon
authors.initials: SK
authors.lastname: Ma
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.forename: Soo Wan
authors.initials: SW
authors.lastname: Kim
mesh_terms: D000368:Aged; D002423:Cause of Death / Q000639:trends; D004305:Dose-Response Relationship, Drug; D004562:Electrocardiography / Q000187:drug effects*; D005260:Female; D005500:Follow-Up Studies; D005919:Glomerular Filtration Rate / Q000187:drug effects / Q000502:physiology*; D017052:Hospital Mortality / Q000639:trends; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000150:complications / Q000401:mortality / Q000628:therapy*; D051437:Renal Insufficiency / Q000150:complications* / Q000401:mortality / Q000503:physiopathology; D056910:Republic of Korea / Q000453:epidemiology; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors