Journal of Lipid and Atherosclerosis, 2019. 8(2), 208-220, DOI: https://doi.org/10.12997/jla.2019.8.2.208

Intensity of Statin Treatment in Korean Patients with Acute Myocardial Infarction and Very Low LDL Cholesterol

Doo Sun Sim, Myung Ho Jeong; Hyeon Cheol Gwon; Ki Bae Seung; Seung Woon Rha; Shung Chull Chae; Chong Jin Kim; Kwang Soo Cha; Jong Seon Park; Jung Han Yoon; Jei Keon Chae; Seung Jae Joo; Dong Ju Choi; Seung Ho Hur; In Whan Seong; Myeong Chan Cho; Doo Il Kim; Seok Kyu Oh; Tae Hoon Ahn; Jin Yong Hwang

Abstract

Objective: Data on the intensity of statin therapy for patients with acute myocardialinfarction (MI) and very low baseline low-density lipoprotein (LDL) cholesterol level arelacking. We sought to assess the impact of statin intensity in patients with acute MI and LDLcholesterol <70 mg/dL.

Methods: A total of 1,086 patients with acute MI and baseline LDL cholesterol <70 mg/dLfrom the Korea Acute Myocardial Infarction Registry-National Institute of Health databasewere divided into less intensive statin (expected LDL reduction <40%, n=302) and moreintensive statin (expected LDL reduction ≥40%, n=784) groups. The primary endpoint wasmajor adverse cardiac and cerebrovascular events (MACCEs), a composite of cardiac death,MI, revascularization occurring at least 30 days after admission, and stroke, at 12 months.

Results: After 1:2 propensity matching, differences were not observed between less intensive(n=302) and more intensive statin (n=604) groups in incidence of cardiac death (0.3% vs. 0.3%)and hemorrhagic stroke (0.3% vs. 0.5%, p=0.727) at 12 months. Compared with the less intensivestatin group, the more intensive statin group showed lower target-vessel revascularization (4.6%vs. 1.8%, p=0.027) and MACCE (11.6% vs. 7.0%, p=0.021). Major bleeding was not differentbetween less intensive and more intensive statin groups (1.0% vs. 2.6%, p=0.118).

Conclusion: More intensive statin therapy was associated with significantly lower majoradverse cardiovascular events in patients with acute MI and very low LDL cholesterolcompared with less intensive statin therapy.

• DOI: https://doi.org/10.12997/jla.2019.8.2.208
• ISBN or ISSN: 2287-2892

• 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
• This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.