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Published online: 2021-01-20
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ST-elevation versus non-ST-elevation myocardial infarction after combined use of statin with renin–angiotensin system inhibitor: Data from the Korea Acute Myocardial Infarction Registry

Yong Hoon Kim, Ae-Young Her, Myung Ho Jeong, Byeong-Keuk Kim, Sung-Jin Hong, Seunghwan Kim, Chul-Min Ahn, Jung-Sun Kim, Young-Guk Ko, Donghoon Choi, Myeong-Ki Hong, Yangsoo Jang
DOI: 10.5603/CJ.a2021.0007
·
Pubmed: 33634844

open access

Ahead of print
Original articles
Published online: 2021-01-20

Abstract

Background: Limited data are available comparing the combined effects of statins and renin–angiotensin system inhibitor (RASI) between patients with ST-segment elevation myocardial infarction (STEMI) and those with non-STEMI (NSTEMI). We compared the effects of statins combined with RASI in STEMI and NSTEMI patients after stent implantation during a long-term follow-up period.

Methods: A total of 21,890 acute myocardial infarction (AMI) patients who underwent successful stent implantation and who received statins with RASI were enrolled. They were separated into the STEMI group (n = 12,490) and the NSTEMI group (n = 9400). The major clinical endpoint was the occurrence of major adverse cardiac events (MACEs) defined as all-cause death, recurrent myocardial infarction (Re-MI), and any repeat revascularization.

Results: Two propensity score-matched (PSM) groups (5891 pairs, n = 11782, C-statistic = 0.821) were generated. Even though the cumulative incidences of MACE, re-MI, total repeat revascularization were similar between the two groups, the cumulative incidences of all-cause death (hazard ratio [HR] 1.407; 95% confidence interval [CI] 1.106–1.790; p = 0.005) and cardiac death (HR 1.311; 95% CI 1.983–1.749; p = 0.046) were significantly higher in the NSTEMI group.

Conclusions: In this study, statin with RASI combination therapy was more beneficial to the STEMI patients than to the NSTEMI patients in reducing all-cause death and cardiac death.

Abstract

Background: Limited data are available comparing the combined effects of statins and renin–angiotensin system inhibitor (RASI) between patients with ST-segment elevation myocardial infarction (STEMI) and those with non-STEMI (NSTEMI). We compared the effects of statins combined with RASI in STEMI and NSTEMI patients after stent implantation during a long-term follow-up period.

Methods: A total of 21,890 acute myocardial infarction (AMI) patients who underwent successful stent implantation and who received statins with RASI were enrolled. They were separated into the STEMI group (n = 12,490) and the NSTEMI group (n = 9400). The major clinical endpoint was the occurrence of major adverse cardiac events (MACEs) defined as all-cause death, recurrent myocardial infarction (Re-MI), and any repeat revascularization.

Results: Two propensity score-matched (PSM) groups (5891 pairs, n = 11782, C-statistic = 0.821) were generated. Even though the cumulative incidences of MACE, re-MI, total repeat revascularization were similar between the two groups, the cumulative incidences of all-cause death (hazard ratio [HR] 1.407; 95% confidence interval [CI] 1.106–1.790; p = 0.005) and cardiac death (HR 1.311; 95% CI 1.983–1.749; p = 0.046) were significantly higher in the NSTEMI group.

Conclusions: In this study, statin with RASI combination therapy was more beneficial to the STEMI patients than to the NSTEMI patients in reducing all-cause death and cardiac death.

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Keywords

non-ST-segment elevation myocardial infarction, renin–angiotensin system, statin, ST-segment elevation myocardial infarction

About this article
Title

ST-elevation versus non-ST-elevation myocardial infarction after combined use of statin with renin–angiotensin system inhibitor: Data from the Korea Acute Myocardial Infarction Registry

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Original Article

Published online

2021-01-20

DOI

10.5603/CJ.a2021.0007

Pubmed

33634844

Keywords

non-ST-segment elevation myocardial infarction
renin–angiotensin system
statin
ST-segment elevation myocardial infarction

Authors

Yong Hoon Kim
Ae-Young Her
Myung Ho Jeong
Byeong-Keuk Kim
Sung-Jin Hong
Seunghwan Kim
Chul-Min Ahn
Jung-Sun Kim
Young-Guk Ko
Donghoon Choi
Myeong-Ki Hong
Yangsoo Jang

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