摘要
BACKGROUND There is insufficient evidence regarding the effect of high-intensity statin therapy in older adults.This study aimed to investigate the effects of high-intensity statin treatment on the clinical outcomes in older adults with myocardial infarc-tion(MI).METHODS Consecutive patients with MI aged at least 75 years were analyzed retrospectively.The primary endpoint was major adverse cardiac and cerebrovascular events(MACCE),defined as a composite of all-cause death,MI,rehospitalization due to un-stable angina,repeat revascularization,and ischemic stroke.The high-intensity group was compared to the low-to-moderate in-tensity group in the propensity score-matched cohort.RESULTS Average age of total 546 patients was 81 years.Among them,84%of patients underwent percutaneous coronary in-tervention.The unadjusted seven-year MACCE rate differed by statin intensity(high-intensity statin group:38%,moderate-intensity statin group:42%,low-intensity statin group:56%,and no-statin group:61%,P=0.004).However,among these groups,many baseline characteristics were significantly different.Among the 74 propensity score-matched pairs,which lacked any significant differences in all baseline characteristics,the high-intensity group had a significantly lower rate of MACCE than the low-to-moderate intensity group(37%vs.53%,P=0.047).Follow-up low-density lipoprotein cholesterol levels were significantly lower in the high-intensity group than that in the low-to-moderate intensity group(69.4±16.0 mg/dL vs.77.9±25.9 mg/dL,P=0.026).CONCLUSIONS In older adult patients with MI,the use of high-intensity statin caused significantly less occurrence of MACCE in comparison to that in low-to-moderate intensity for up to seven years of follow-up.
