Influence of High-Dose Highly Efficient Statins on Short-Term Mortality in Patients Undergoing Percutaneous Coronary Intervention With Stenting for Acute Coronary Syndromes

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• 作者：Ioannis Tentzeris ; MD^a ; ^{i_tentzeris@gmx.net" class="auth_mail} ; Miklos Rohla^a ; Rudolf Jarai ; MD^a ; Serdar Farhan ; MD^a ; Matthias K. Freynhofer ; MD^a ; Gerhard Unger ; MD^a ; Michael Nü ; rnberg ; MD^a ; Alexander Geppert ; MD^a ; Emil Wessely ; MD^a ; Johann Wojta ; PhD^b ; Kurt Huber ; MD^a
• 刊名：The American Journal of Cardiology
• 出版年：1 April, 2014
• 年：2014
• 卷：113
• 期：7
• 页码：1099-1104
• 全文大小：458 K

文摘

Statins are recommended for prevention of progression of cardiovascular disease after percutaneous coronary intervention (PCI). Although high-dose highly efficient statins are recommended, especially in high-risk patients, clinical data are scarce and further investigation in 鈥渞eal-world鈥?settings is needed. One thousand five hundred twenty-eight consecutive patients, who underwent PCI for acute coronary syndrome, were included in a prospective registry from January 2003 to January 2011. In post hoc analysis, cardiovascular risk factors, co-morbidities, and circulating lipid parameters at the time of intervention were evaluated. As a primary end point, all-cause mortality after a follow-up period of 3聽months was investigated. Results were compared between patients receiving high-dose highly effective statins (atorvastatin 80聽mg or rosuvastatin 20聽mg) versus patients receiving low-dose statins or who were without lipid-lowering therapy at the time of discharge. Nine hundred twenty-six patients (60.6%) received high-dose atorvastatin or rosuvastatin and 602 patients (39.4%) received low-dose statin therapy or were not on statins at discharge. Eight patients (0.9%) receiving high-dose statin therapy and 21 patients (3.5%) taking low-dose statins or no statins at discharge died during the 3-month follow-up (hazard ratio 0.244, 95% confidence interval 0.108 to 0.551, p聽= 0.001). After propensity score adjustment the results remained significant (adjusted hazard ratio for high-dose statins 0.405, 95% confidence interval 0.176聽to聽0.931, p聽= 0.033). In conclusion, in this single-center series of 1,528 real-world patients undergoing PCI for acute coronary syndrome, a significant reduction in short-term all-cause mortality could be demonstrated in patients receiving high-dose highly efficient statins compared with patients receiving low-dose statins or no lipid-lowering therapy.