Effects of Statin Therapy on Clinical Outcomes of Survivors of Acute Myocardial Infarction with Severe Systolic Heart Failure

• Published in: PloS one Vol. 10; no. 12; p. e0144602
• Main Authors: Woo, Jong Shin, Hwang, Seung Joon, Kim, Hyun Soo, Kim, Jin Bae, Kim, Woo-Shik, Kim, Kwon Sam, Jeong, Myung Ho, Kim, Weon
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 11-12-2015; Public Library of Science (PLoS)
• Subjects: Aged; Atherosclerosis; Cardiology; Cardiovascular disease; Care and treatment; Cholesterol; Clinical outcomes; Clinical trials; Complications and side effects; Coronary vessels; Data bases; Demographics; Dosage and administration; Drug therapy; Enzyme Inhibitors - therapeutic use; Family medical history; Female; Health risk assessment; Heart; Heart attack; Heart attacks; Heart diseases; Heart failure; Heart Failure, Systolic - complications; Heart Failure, Systolic - drug therapy; Heart Failure, Systolic - mortality; Heart Failure, Systolic - pathology; Heart surgery; Hospitals; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Infarction; Internal medicine; Long-term effects; Male; Medicine; Middle Aged; Mortality; Myocardial infarction; Myocardial Infarction - complications; Myocardial Infarction - drug therapy; Myocardial Infarction - mortality; Myocardial Infarction - pathology; Patient outcomes; Patients; Proportional Hazards Models; Registries; Regression analysis; Republic of Korea; Retrospective Studies; Review boards; Statins; Survival Analysis; Task forces; Therapy; Treatment Outcome; Ventricle; Ventricular Function, Left; Republic of Korea; South Korea
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0144602

Large randomized trials have failed to show a beneficial effect of statin treatment in chronic HF. The investigators tried to evaluate the long-term effects of statin therapy in patients with new onset heart failure (HF) following acute myocardial infarction (AMI).
Between January 2008 and December 2011, a total of 13,616 AMI patients were enrolled in the Korea Acute Myocardial Infarction Registry (KAMIR) which was a prospective, multi-center, nationwide, web-based database of AMI in Korea. From this database, we studied 1,055 patients with AMI who had newly developed severe acute HF [left ventricular ejection fraction ≤ 40%] and were discharged alive. The patients were divided into two groups, a statin group (n = 756) and a no-statin group (n = 299). We investigated the one-year major adverse cardiovascular events (MACEs), including all-cause mortality, MI, and any revascularization of each group. We then performed a propensity-score matched analysis.
In the original cohort, one-year MACEs were similar between the two groups (16.5% vs. 14.7% in the statin or no-statin groups; p = 0.47). Propensity-score matching yielded 256 pairs, and in that population we observed comparable results in terms of MACEs (18.0% vs. 12.5% in the statin or no-statin groups, p = 0.11) and mortality (5.1% vs. 3.5% in the statin or no-statin groups, p = 0.51). Cox-regression analysis revealed that statin therapy was not an independent predictor for occurrence of a MACE [Hazard ratio (HR) 1.11, 95% CI 0.79-1.57, p = 0.54] or all-cause mortality (HR 1.42, 95% CI 0.75-2.70, p = 0.28).
Statin therapy was not associated with a reduction in the long-term occurrence of MACEs or mortality in survivors of AMI with severe acute HF in this retrospective cohort study.