title: [Early statin therapy in acute myocardial infarction].
abstract: OBJECTIVE
  To evaluate the effects of the early administration of statins during acute myocardial infarction (MI).
  
  
  METHODS
  A retrospective cohort study was carried out.
  
  
  METHODS
  National (Spain).
  
  
  METHODS
  Patients included in the ARIAM registry from January 1999 to December 2008 with a diagnosis of MI.
  
  
  METHODS
  None.
  
  
  METHODS
  We used logistic regression analysis and propensity scoring to determine whether the administration of statins during the first 24h of MI acts as a protective factor against: 1) mortality, 2) the incidence of lethal arrhythmias, or 3) cardiogenic shock.
  
  
  RESULTS
  A total of 36 842 patients were included in the study. Statins were administered early in 50.2% of the patients. Statin administration was associated with younger patients with known previous dyslipidemia, obesity, a history of ischemic heart disease, heart failure, presence of sinus tachycardia, use of beta-blockers, angiotensin-converting enzyme inhibitors, thrombolysis and percutaneous coronary intervention. Mortality was 8.2% (13.2% without statin versus 3% with statin, P<.001). Multivariate analysis demonstrated that statin administration acted as a protective factor against mortality (adjusted OR 0.518, 95%CI 0.447 to 0.601). Continued use of statins was associated with a reduction in mortality (adjusted OR 0.597, 95%CI 0.449 to 0.798), and the start of treatment was a protective factor against mortality (adjusted OR 0.642, 95%CI 0.544 -0.757). Statin therapy also exerted a protective effect against the incidence of lethal arrhythmias and cardiogenic shock.
  
  
  CONCLUSIONS
  These results suggest that early treatment with statins in patients with MI is associated with reduced mortality.
authors.affiliation: Unidad de Gestión Clínica de Cuidados Críticos y Urgencias, Hospital Médico-Quirúrgico del Complejo Hospitalario de Jaén, Jaén, España. Electronic address: ruizbailen@gmal.com.
authors.forename: M
authors.initials: M
authors.lastname: Ruiz-Bailén
authors.affiliation: Clínica Jerez ASISA, Jerez, Cádiz, España.
authors.forename: F J
authors.initials: FJ
authors.lastname: Romero-Bermejo
authors.affiliation: Unidad de Investigación, Hospital Médico-Quirúrgico del Complejo Hospitalario de Jaén, Jaén, España.
authors.forename: M
authors.initials: M
authors.lastname: Expósito-Ruiz
authors.affiliation: Unidad de Gestión Clínica de Cuidados Críticos y Urgencias, Hospital Médico-Quirúrgico del Complejo Hospitalario de Jaén, Jaén, España.
authors.forename: F
authors.initials: F
authors.lastname: Zamora-Zamora
authors.affiliation: Departamento de Ciencias de la Salud, Universidad de Jaén, Jaén, España.
authors.forename: M J
authors.initials: MJ
authors.lastname: Martínez-Ramírez
authors.affiliation: Unidad de Gestión Clínica de Cuidados Críticos y Urgencias, Hospital Médico-Quirúrgico del Complejo Hospitalario de Jaén, Jaén, España.
authors.forename: A M
authors.initials: AM
authors.lastname: Castillo-Rivera
authors.affiliation: Unidad de Gestión Clínica de Cuidados Críticos y Urgencias, Hospital de Torrecárdenas, Almería, España.
authors.forename: J A
authors.initials: JA
authors.lastname: Ramos-Cuadra
authors.affiliation: Departamento de Ciencias de la Salud, Universidad de Jaén, Jaén, España.
authors.forename: M
authors.initials: M
authors.lastname: Ramírez-Sánchez
authors.affiliation: Servicio de Cardiología, Hospital Universitario Puerta del Mar, Cádiz, España.
authors.forename: R
authors.initials: R
authors.lastname: Vázquez-García
mesh_terms: D015331:Cohort Studies; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy*; D012189:Retrospective Studies; D055502:Secondary Prevention
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Análisis de propensión; Estatinas; Infarto de miocardio; Mortalidad; Mortality; Myocardial infarction; Propensity score analysis; Statins; Thrombolysis; Trombolisis