title: Effect of Statin Treatment and Low-Density Lipoprotein-Cholesterol on Short-Term Mortality in Acute Myocardial Infarction Patients Undergoing Primary Percutaneous Coronary Intervention - Multicenter Registry From Tokyo CCU Network Database.
abstract: BACKGROUND
  Previous trials have found that low low-density lipoprotein-cholesterol (LDL-C) on admission was associated with increased mortality in patients with acute myocardial infarction (AMI). There are few reports, however, on the effect of low LDL-C with or without in-hospital statin treatment on short-term prognosis in AMI patients.
  
  
  RESULTS
  A total of 9,032 AMI patients underwent primary PCI in 68 centers in the Tokyo CCU Network Registry during 2009-2012, in whom LDL-C was measured in 6,486. We divided them into 4 groups: statin-treated/LDL-C <100 mg/dl (n=1,236), statin-treated/LDL-C ≥ 100 mg/dl (n=3,671), statin-naïve/LDL-C <100 mg/dl (n=662), and statin-naïve/LDL-C ≥ 100 mg/dl (n=917). We assessed hospital mortality within 30 days. In-hospital all-cause mortality was significantly lower in the statin-treated/LDL-C ≥ 100-mg/dl group (3.2%, P<0.001). On multivariate Cox regression analysis, adjusted for age, gender, hypertension, diabetes mellitus, dyslipidemia and other clinical factors, the combination of statin treatment and LDL-C ≥ 100 mg/dl was an independent predictor of lower in-hospital mortality (adjusted HR, 0.211; 95% CI: 0.096-0.462; P<0.001). In the LDL-C <100-mg/dl patients, statin treatment also independently reduced in-hospital mortality (adjusted HR, 0.467; 95% CI: 0.223-0.976; P=0.043). Spontaneously low LDL-C was associated with increased short-term mortality.
  
  
  CONCLUSIONS
  Statin treatment was associated with better short-term outcome in patients with AMI, even in patients with low LDL-C.
authors.affiliation: Department of Cardiovascular Medicine, The University of Tokyo Hospital.
authors.forename: Mizuki
authors.initials: M
authors.lastname: Miura
authors.forename: Masao
authors.initials: M
authors.lastname: Yamasaki
authors.forename: Yukari
authors.initials: Y
authors.lastname: Uemura
authors.forename: Masatomo
authors.initials: M
authors.lastname: Yoshikawa
authors.forename: Katsumi
authors.initials: K
authors.lastname: Miyauchi
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Tanaka
authors.forename: Hideki
authors.initials: H
authors.lastname: Miyachi
authors.forename: Jun
authors.initials: J
authors.lastname: Yamashita
authors.forename: Makoto
authors.initials: M
authors.lastname: Suzuki
authors.forename: Takeshi
authors.initials: T
authors.lastname: Yamamoto
authors.forename: Ken
authors.initials: K
authors.lastname: Nagao
authors.forename: Issei
authors.initials: I
authors.lastname: Komuro
authors.forename: Morimasa
authors.initials: M
authors.lastname: Takayama
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D008078:Cholesterol, LDL / Q000097:blood*; D016208:Databases, Factual; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000097:blood / Q000401:mortality / Q000628:therapy; D062645:Percutaneous Coronary Intervention; D012042:Registries
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors