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

• Published in: Journal of lipid and atherosclerosis Vol. 8; no. 2; pp. 208 - 220
• Main Authors: Sim, Doo Sun, Jeong, Myung Ho, Kim, Hyo Soo, Gwon, Hyeon Cheol, Seung, Ki Bae, Rha, Seung Woon, Chae, Shung Chull, Kim, Chong Jin, Cha, Kwang Soo, Park, Jong Seon, Yoon, Jung Han, Chae, Jei Keon, Joo, Seung Jae, Choi, Dong Ju, Hur, Seung Ho, Seong, In Whan, Cho, Myeong Chan, Kim, Doo Il, Oh, Seok Kyu, Ahn, Tae Hoon, Hwang, Jin Yong
• Format: Journal Article
• Language: English
• Published: Korea (South) Korean Society of Lipidology and Atherosclerosis 01.09.2019; 한국지질동맥경화학회
• Subjects: Original; 내과학; Myocardial infarction; Cholesterol; Statins
• ISSN: 2287-2892; 2288-2561
• DOI: 10.12997/jla.2019.8.2.208

Data on the intensity of statin therapy for patients with acute myocardial infarction (MI) and very low baseline low-density lipoprotein (LDL) cholesterol level are lacking. We sought to assess the impact of statin intensity in patients with acute MI and LDL cholesterol <70 mg/dL. A total of 1,086 patients with acute MI and baseline LDL cholesterol <70 mg/dL from the Korea Acute Myocardial Infarction Registry-National Institute of Health database were divided into less intensive statin (expected LDL reduction <40%, n=302) and more intensive statin (expected LDL reduction ≥40%, n=784) groups. The primary endpoint was major 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. 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%, =0.727) at 12 months. Compared with the less intensive statin group, the more intensive statin group showed lower target-vessel revascularization (4.6% vs. 1.8%, =0.027) and MACCE (11.6% vs. 7.0%, =0.021). Major bleeding was not different between less intensive and more intensive statin groups (1.0% vs. 2.6%, =0.118). More intensive statin therapy was associated with significantly lower major adverse cardiovascular events in patients with acute MI and very low LDL cholesterol compared with less intensive statin therapy.