title: Benefit of statin therapy in patients with coronary spasm-induced acute myocardial infarction.
abstract: Coronary artery spasm is associated with vascular smooth muscle hyper-reactivity. Statins suppress coronary spasm by inhibiting the vascular smooth muscle contraction. However, it is unclear whether statin therapy benefits patients with coronary spasm-induced acute myocardial infarction (AMI).
  
  
  
  We analyzed 501 (median age 57 years; male/female, 346/155) patients with coronary spasm-induced AMI with nonobstructive coronary arteries (stenosis severity <50%) from the Korea AMI Registry between November 2005 and October 2013. They were divided into two groups according to statin prescription at discharge (statin group n=292; nonstatin group n=209). The primary endpoint was the composite of 12-month major adverse cardiac events, including all causes of death, non-fatal myocardial infarction, and target vessel revascularization. The primary endpoint occurred in 17 patients during 12 months of follow-up. Statin therapy significantly reduced the risk of the composite primary endpoint [adjusted hazard ratio (HR): 0.30; 95% confidence interval (CI): 0.09-0.97; p=0.045]. Statin therapy reduced the risk of myocardial infarction (HR: 0.19; 95% CI: 0.04-0.93; p=0.040). However, we found no significant difference in the risk of the composite of all-cause death.
  
  
  
  Statin therapy in patients with coronary spasm-induced AMI with nonobstructive coronary arteries was associated with improved clinical outcome, which was predominantly accounted for by reducing the incidence of myocardial infarction.
authors.affiliation: Chonnam National University Hospital, Gwangju, Republic of Korea; Jilin Hospital Affiliated with Jilin University, Jilin, China.
authors.forename: Zhe Hao
authors.initials: ZH
authors.lastname: Piao
authors.affiliation: Chonnam National University Hospital, Gwangju, Republic of Korea. Electronic address: myungho@chollian.net.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.affiliation: Jilin Hospital Affiliated with Jilin University, Jilin, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Li
authors.affiliation: Jilin Hospital Affiliated with Jilin University, Jilin, China.
authors.forename: Li
authors.initials: L
authors.lastname: Jin
authors.affiliation: Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Hyun Kuk
authors.initials: HK
authors.lastname: Kim
authors.affiliation: Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Keun-Ho
authors.initials: KH
authors.lastname: Park
authors.affiliation: Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Doo Sun
authors.initials: DS
authors.lastname: Sim
authors.affiliation: Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Kye Hun
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.affiliation: Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: HyungWook
authors.initials: H
authors.lastname: Park
authors.affiliation: Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Ju Han
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Youngkeun
authors.initials: Y
authors.lastname: Ahn
authors.affiliation: Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Jeong Gwan
authors.initials: JG
authors.lastname: Cho
authors.affiliation: Chonnam National University Hospital, Gwangju, Republic of Korea.
authors.forename: Jong Chun
authors.initials: JC
authors.lastname: Park
authors.affiliation: Yeungnam University Hospital, Daegu, Republic of Korea.
authors.forename: Young Jo
authors.initials: YJ
authors.lastname: Kim
authors.affiliation: Chungbuk National University Hospital, Cheongju, Republic of Korea.
authors.forename: Myeong Chan
authors.initials: MC
authors.lastname: Cho
authors.affiliation: Kyung Hee University Hospital, Seoul, Republic of Korea.
authors.forename: Chong Jin
authors.initials: CJ
authors.lastname: Kim
authors.affiliation: Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Hyo-Soo
authors.initials: HS
authors.lastname: Kim
mesh_terms: D000368:Aged; D003329:Coronary Vasospasm / Q000150:complications*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000209:etiology*; D016016:Proportional Hazards Models; D012042:Registries; D056910:Republic of Korea; D016896:Treatment Outcome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: Coronary vasospasm; Myocardial infarction; Prognosis; Statin