Effect of statin treatment in patients with acute myocardial infarction and left ventricular systolic dysfunction according to the level of high-sensitivity C-reactive protein

Hae Chang Jeong, Youngkeun Ahn, Keun Ho Park, Doo Sun Sim, Young Joon Hong, Ju Han Kim, Myung Ho Jeong, Young Jo Kim, Shung Chull Chae, Myeong Chan Cho, Jei Keon Chae, Chong Jin Kim, Seung-Woon Rha, Yang Soo Jang, Seok Kyu Oh, In Whan Seong, Kwang Soo Cha

Research output: Contribution to journalArticle

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Abstract

The effects of statins on the prognosis of patients with left ventricular (LV) systolic dysfunction remain controversial. The aim of this study was to assess the effect of statin treatment on clinical outcomes in acute myocardial infarction (AMI) patients with LV systolic dysfunction. A total of 5,119 AMI patients with LV ejection fraction less than 50% on the initial echocardiogram were analyzed in the Korean Acute Myocardial Infarction Registry. The study population was divided into 4 groups according to the level of high sensitivity C-reactive protein (hs-CRP) and statin treatment: low hs- CRP (hs-CRP ≤ 2.0 mg/L) and high hs-CRP (hs-CRP > 2 mg/L) with or without statin therapy. We evaluated the incidence of major adverse cardiac events (MACEs) including cardiac death, reinfarction, target lesion revascularization, and coronary artery bypass grafting during a 12-month period in each group. Statin therapy did not significantly prevent the MACEs in the low hs-CRP groups (with statin: 10.1% versus without statin: 12.0%, P = 0.249). In the high hs-CRP groups, however, the incidence of MACEs was significantly decreased with statin treatment (with statin: 11.3%, without statin: 20.8%, P < 0.001). These findings were consistently observed in all subgroups of the high-hs CRP group, including the subgroup with an LV ejection fraction less than 40%. In a multivariable logistic regression analysis of the high hs-CRP group, lack of statin therapy was a signifi cant predictor of MACE incidence (odds ratio: 1.573, 95% confidence interval: 1.079-2.293, P = 0.018). The statin treatment was associated with better outcome in AMI and LV dysfunction patients with hs-CRP ≥ 2 mg/dL.

Original languageEnglish
Pages (from-to)106-112
Number of pages7
JournalInternational Heart Journal
Volume55
Issue number2
DOIs
Publication statusPublished - 2014 Jan 1

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Left Ventricular Dysfunction
C-Reactive Protein
Myocardial Infarction
Therapeutics
Stroke Volume
Incidence
Coronary Artery Bypass
Registries

Keywords

  • Coronary artery disease
  • Infl ammation
  • Prognosis

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Effect of statin treatment in patients with acute myocardial infarction and left ventricular systolic dysfunction according to the level of high-sensitivity C-reactive protein. / Jeong, Hae Chang; Ahn, Youngkeun; Park, Keun Ho; Sim, Doo Sun; Hong, Young Joon; Kim, Ju Han; Jeong, Myung Ho; Kim, Young Jo; Chae, Shung Chull; Cho, Myeong Chan; Chae, Jei Keon; Kim, Chong Jin; Rha, Seung-Woon; Jang, Yang Soo; Oh, Seok Kyu; Seong, In Whan; Cha, Kwang Soo.

In: International Heart Journal, Vol. 55, No. 2, 01.01.2014, p. 106-112.

Research output: Contribution to journalArticle

Jeong, HC, Ahn, Y, Park, KH, Sim, DS, Hong, YJ, Kim, JH, Jeong, MH, Kim, YJ, Chae, SC, Cho, MC, Chae, JK, Kim, CJ, Rha, S-W, Jang, YS, Oh, SK, Seong, IW & Cha, KS 2014, 'Effect of statin treatment in patients with acute myocardial infarction and left ventricular systolic dysfunction according to the level of high-sensitivity C-reactive protein', International Heart Journal, vol. 55, no. 2, pp. 106-112. https://doi.org/10.1536/ihj.13-223
Jeong, Hae Chang ; Ahn, Youngkeun ; Park, Keun Ho ; Sim, Doo Sun ; Hong, Young Joon ; Kim, Ju Han ; Jeong, Myung Ho ; Kim, Young Jo ; Chae, Shung Chull ; Cho, Myeong Chan ; Chae, Jei Keon ; Kim, Chong Jin ; Rha, Seung-Woon ; Jang, Yang Soo ; Oh, Seok Kyu ; Seong, In Whan ; Cha, Kwang Soo. / Effect of statin treatment in patients with acute myocardial infarction and left ventricular systolic dysfunction according to the level of high-sensitivity C-reactive protein. In: International Heart Journal. 2014 ; Vol. 55, No. 2. pp. 106-112.
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abstract = "The effects of statins on the prognosis of patients with left ventricular (LV) systolic dysfunction remain controversial. The aim of this study was to assess the effect of statin treatment on clinical outcomes in acute myocardial infarction (AMI) patients with LV systolic dysfunction. A total of 5,119 AMI patients with LV ejection fraction less than 50{\%} on the initial echocardiogram were analyzed in the Korean Acute Myocardial Infarction Registry. The study population was divided into 4 groups according to the level of high sensitivity C-reactive protein (hs-CRP) and statin treatment: low hs- CRP (hs-CRP ≤ 2.0 mg/L) and high hs-CRP (hs-CRP > 2 mg/L) with or without statin therapy. We evaluated the incidence of major adverse cardiac events (MACEs) including cardiac death, reinfarction, target lesion revascularization, and coronary artery bypass grafting during a 12-month period in each group. Statin therapy did not significantly prevent the MACEs in the low hs-CRP groups (with statin: 10.1{\%} versus without statin: 12.0{\%}, P = 0.249). In the high hs-CRP groups, however, the incidence of MACEs was significantly decreased with statin treatment (with statin: 11.3{\%}, without statin: 20.8{\%}, P < 0.001). These findings were consistently observed in all subgroups of the high-hs CRP group, including the subgroup with an LV ejection fraction less than 40{\%}. In a multivariable logistic regression analysis of the high hs-CRP group, lack of statin therapy was a signifi cant predictor of MACE incidence (odds ratio: 1.573, 95{\%} confidence interval: 1.079-2.293, P = 0.018). The statin treatment was associated with better outcome in AMI and LV dysfunction patients with hs-CRP ≥ 2 mg/dL.",
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AU - Hong, Young Joon

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AU - Kim, Young Jo

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N2 - The effects of statins on the prognosis of patients with left ventricular (LV) systolic dysfunction remain controversial. The aim of this study was to assess the effect of statin treatment on clinical outcomes in acute myocardial infarction (AMI) patients with LV systolic dysfunction. A total of 5,119 AMI patients with LV ejection fraction less than 50% on the initial echocardiogram were analyzed in the Korean Acute Myocardial Infarction Registry. The study population was divided into 4 groups according to the level of high sensitivity C-reactive protein (hs-CRP) and statin treatment: low hs- CRP (hs-CRP ≤ 2.0 mg/L) and high hs-CRP (hs-CRP > 2 mg/L) with or without statin therapy. We evaluated the incidence of major adverse cardiac events (MACEs) including cardiac death, reinfarction, target lesion revascularization, and coronary artery bypass grafting during a 12-month period in each group. Statin therapy did not significantly prevent the MACEs in the low hs-CRP groups (with statin: 10.1% versus without statin: 12.0%, P = 0.249). In the high hs-CRP groups, however, the incidence of MACEs was significantly decreased with statin treatment (with statin: 11.3%, without statin: 20.8%, P < 0.001). These findings were consistently observed in all subgroups of the high-hs CRP group, including the subgroup with an LV ejection fraction less than 40%. In a multivariable logistic regression analysis of the high hs-CRP group, lack of statin therapy was a signifi cant predictor of MACE incidence (odds ratio: 1.573, 95% confidence interval: 1.079-2.293, P = 0.018). The statin treatment was associated with better outcome in AMI and LV dysfunction patients with hs-CRP ≥ 2 mg/dL.

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