Background The benefit of statin use after acute ST-segment elevation myocardial infarction （STEMI） has been well established, however, the influence of the timing of statin administration has not been elucidated. T...Background The benefit of statin use after acute ST-segment elevation myocardial infarction （STEMI） has been well established, however, the influence of the timing of statin administration has not been elucidated. The objective of this study focused on early clinical outcomes after percutaneous coronary intervention （PCI）. Methods This analysis of the Korea Working Group on Myocardial Infarction registry （KorMI） study included 3,584 STEMI patients （mean age, 63 ±13 years;male, 2,684, 74.9%） undergoing PCI from January 2008 to June 2009. Rates of major adverse cardiac events （MACE：all-cause death, recurrent MI, and target lesion revascularization） were compared among patients grouped according to statin therapy timing：I, both during and after hospitalization （n=2,653, 74%）;II, only during hospita-lization （n=309, 8.6%）;III, only after discharge （n=157, 4.4%）;and IV, no statin therapy （n=465, 13%）. Mean follow-up duration was 234 ± 113 days. Results Multivariate factors of statin use during hospitalization included prior statin use, multiple diseased vessels, final thrombolysis in myocardial infarction flow grade III, and low-density lipoprotein cholesterol level. At 6-month follow-up, groups Ⅲ and Ⅳ had the highest MACE rates （2.3%, 3.9%, 5.1%, and 4.9%for groups I-IV, respectively, P=0.004）. After adjusting for confounders, groups Ⅱ-Ⅳ had a higher MACE risk than group Ⅰ [hazard ratio （HR）：3.20, 95%confidence interval （95%CI）：1.31-7.86, P=0.011;HR：3.84, 95%CI：1.47-10.02, P=0.006;and HR：3.17, 95%CI：1.59-6.40, P=0.001;respectively]. Conclusions This study, based on the national registry database, shows early and continuous statin therapy improvs early outcomes of STEMI patients after PCI in real-world clinical prac-tice.展开更多
目的：探讨经皮冠状动脉介入（PCI）术前,负荷剂量阿托伐他汀的强化治疗,对高龄老年冠心病患者预后的影响。方法：入选年龄在70-82岁择期行PCI的患者共300例,随机分为常规治疗组和强化治疗组,观察术后心肌标志物及高敏C反应蛋白（hs-CR...目的：探讨经皮冠状动脉介入（PCI）术前,负荷剂量阿托伐他汀的强化治疗,对高龄老年冠心病患者预后的影响。方法：入选年龄在70-82岁择期行PCI的患者共300例,随机分为常规治疗组和强化治疗组,观察术后心肌标志物及高敏C反应蛋白（hs-CRP）的水平变化及术后1个月和12个月主要不良心脏事件（MACE,包括心源性死亡、心肌梗死和靶血管血运重建）的发生率。结果：常规治疗组术后24 h c TNI和hs-CRP高于强化治疗组（P=0.04和P=0.01）。强化他汀治疗组PCI术后与PCI相关心肌梗死发生率明显低于常规治疗组（12.1%vs.21.8%,P=0.047）。强化他汀治疗组中12个月时LDL≤1.8 mmol/L比率更高（10.1%vs.4.0%,P=0.04）。12个月时MACE事件发生率强化治疗组低于常规治疗组（9.4%vs.17.2%,P=0.046）。结论：高龄冠心病患者择期PCI术前强化阿托伐他汀钙80 mg/d可以显著减少与PCI相关的心肌梗死,并且安全性良好。展开更多
文摘Background The benefit of statin use after acute ST-segment elevation myocardial infarction （STEMI） has been well established, however, the influence of the timing of statin administration has not been elucidated. The objective of this study focused on early clinical outcomes after percutaneous coronary intervention （PCI）. Methods This analysis of the Korea Working Group on Myocardial Infarction registry （KorMI） study included 3,584 STEMI patients （mean age, 63 ±13 years;male, 2,684, 74.9%） undergoing PCI from January 2008 to June 2009. Rates of major adverse cardiac events （MACE：all-cause death, recurrent MI, and target lesion revascularization） were compared among patients grouped according to statin therapy timing：I, both during and after hospitalization （n=2,653, 74%）;II, only during hospita-lization （n=309, 8.6%）;III, only after discharge （n=157, 4.4%）;and IV, no statin therapy （n=465, 13%）. Mean follow-up duration was 234 ± 113 days. Results Multivariate factors of statin use during hospitalization included prior statin use, multiple diseased vessels, final thrombolysis in myocardial infarction flow grade III, and low-density lipoprotein cholesterol level. At 6-month follow-up, groups Ⅲ and Ⅳ had the highest MACE rates （2.3%, 3.9%, 5.1%, and 4.9%for groups I-IV, respectively, P=0.004）. After adjusting for confounders, groups Ⅱ-Ⅳ had a higher MACE risk than group Ⅰ [hazard ratio （HR）：3.20, 95%confidence interval （95%CI）：1.31-7.86, P=0.011;HR：3.84, 95%CI：1.47-10.02, P=0.006;and HR：3.17, 95%CI：1.59-6.40, P=0.001;respectively]. Conclusions This study, based on the national registry database, shows early and continuous statin therapy improvs early outcomes of STEMI patients after PCI in real-world clinical prac-tice.
文摘目的：探讨经皮冠状动脉介入（PCI）术前,负荷剂量阿托伐他汀的强化治疗,对高龄老年冠心病患者预后的影响。方法：入选年龄在70-82岁择期行PCI的患者共300例,随机分为常规治疗组和强化治疗组,观察术后心肌标志物及高敏C反应蛋白（hs-CRP）的水平变化及术后1个月和12个月主要不良心脏事件（MACE,包括心源性死亡、心肌梗死和靶血管血运重建）的发生率。结果：常规治疗组术后24 h c TNI和hs-CRP高于强化治疗组（P=0.04和P=0.01）。强化他汀治疗组PCI术后与PCI相关心肌梗死发生率明显低于常规治疗组（12.1%vs.21.8%,P=0.047）。强化他汀治疗组中12个月时LDL≤1.8 mmol/L比率更高（10.1%vs.4.0%,P=0.04）。12个月时MACE事件发生率强化治疗组低于常规治疗组（9.4%vs.17.2%,P=0.046）。结论：高龄冠心病患者择期PCI术前强化阿托伐他汀钙80 mg/d可以显著减少与PCI相关的心肌梗死,并且安全性良好。
