Impact of statin therapy at discharge on 1-year mortality in patients with ST-segment elevation myocardial infarction treated with primary angioplasty
Impact of statin therapy at discharge on 1-year mortality in patients with ST-segment elevation myocardial infarction treated with primary angioplasty
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DOI：
10.1016/j.atherosclerosis.2005.11.028
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发表时间：
2006-11-01
期刊：
影响因子：
5.3
通讯作者：
de Boer, Menko-Jan
中科院分区：
文献类型：
--
作者：
De Luca, Giuseppe;Suryapranata, Harry;de Boer, Menko-Jan
背景：斯大林治疗可以降低几类冠心病患者的长期死亡率，但ST段抬高心肌梗死(STEMI)直接血管成形术后的益处尚未确定。本研究的目的是确定他汀类药物治疗是否与直接血管成形术治疗的STEMI患者的死亡率降低有关。方法：1997年4月至2001年10月期间，共有1513名因STEMI接受直接血管成形术的住院幸存者。出院时按他汀类药物治疗分为两组(他汀组893例，对照组620例)。术后1年进行临床随访。结果：1年后，他汀类药物治疗的死亡率显著降低(1.2%比7.1%，R-2[95%CI]=0.16[0.09-0.32]，p<；0.0001)。根据倾向评分和多因素分析(调整后的R-2[95%CI]=0.24[0.12-0.47]，p，<；0.0001)，这些益处在所有亚组中都得到了证实。结论：出院时接受斯大林治疗与STEMI初次血管成形术后1年死亡率显著降低有关。因此，强烈建议在这些患者中使用他汀类药物。(C)2005爱思唯尔爱尔兰有限公司。保留所有权利。
Background: Stalin therapy can reduce long-term mortality in several subgroups of patients with coronary artery disease, but the benefits after primary angioplasty for ST-segment elevation myocardial infarction (STEMI) have yet to be established. The aim of the current study was to determine whether statin therapy is associated with a reduction in mortality in patients with STEMI treated with primary angioplasty.Methods: Our population is represented by a total of 1513 consecutive in-hospital survivors treated with primary angioplasty for STEMI between April 1997 and October 2001. Patients were divided in two groups according to statin therapy (statin group, n=893; control group, n=620) at discharge. Clinical follow-up was performed at 1 year. A propensity score, built on the basis of variables independently associated with statin prescription, was used to investigate the benefits from statin therapy in subgroups of patients that were homogeneous in terms of baseline clinical and angiographic characteristics.Results: At 1-year follow-up statin therapy was associated with a significantly lower mortality (1.2% versus 7.1%, R-2 [95% CI] = 0.16 [0.09-0.32], p < 0.0001). These benefits were confirmed in all subgroups according to the propensity score, and at multivariate analysis (adjusted R-2 [95% CI] = 0.24 [0.12-0.47], p,< 0.0001).Conclusions: Stalin therapy at discharge was associated with a significant reduction in 1-year mortality after primary angioplasty for STEMI. Therefore, the use of statins is highly recommended in these patients. (c) 2005 Elsevier Ireland Ltd. All rights reserved.