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Effect of Early Statin Treatment in Patients with Cardiogenic Shock Complicating Acute Myocardial Infarction

  • Sim, Doo Sun (Department of Cardiovascular Medicine, Chonnam National University College of Medicine) ;
  • Jeong, Myung Ho (Department of Cardiovascular Medicine, Chonnam National University College of Medicine) ;
  • Cho, Kyung Hoon (Department of Cardiovascular Medicine, Chonnam National University College of Medicine) ;
  • Ahn, Youngkeun (Department of Cardiovascular Medicine, Chonnam National University College of Medicine) ;
  • Kim, Young Jo (Department of Cardiology, Yeungnam University College of Medicine) ;
  • Chae, Shung Chull (Department of Cardiology, Kyungpuk National University College of Medicine) ;
  • Hong, Taek Jong (Department of Cardiology, Busan National University College of Medicine) ;
  • Seong, In Whan (Department of Cardiology, Chungnam National University College of Medicine) ;
  • Chae, Jei Keon (Department of Cardiology, Chonbuk National University College of Medicine) ;
  • Kim, Chong Jin (Department of Cardiovascular Medicine, Kyung Hee University College of Medicine) ;
  • Cho, Myeong Chan (Department of Cardiology, Chungbuk National University College of Medicine) ;
  • Rha, Seung-Woon (Department of Cardiology, Korea University College of Medicine, Guro Hospital) ;
  • Bae, Jang Ho (Department of Cardiology, Konyang University College of Medicine) ;
  • Seung, Ki Bae (Department of Cardiovascular Medicine, The Catholic University of Korea College of Medicine) ;
  • Park, Seung Jung (Department of Cardiology, University of Ulsan College of Medicine, Asan Medical Center) ;
  • Korea Acute Myocardial Infarction Registry (KAMIR) Investigators, Korea Acute Myocardial Infarction Registry (KAMIR) Investigators (Korea Acute Myocardial Infarction Registry (KAMIR) Investigators)
  • Published : 2013.02.28

Abstract

Background and Objectives: The benefit of early statin treatment following acute myocardial infarction (MI) complicated with cardiogenic shock (CS) has not been well studied. We sought to assess the effect of early statin therapy in patients with CS complicating acute MI. Subjects and Methods: We studied 553 statin-$na\ddot{i}ve$ patients with acute MI and CS (Killip class IV) who underwent revascularization therapy between November 2005 and January 2008 at 51 hospitals in the Korea Acute Myocardial Infarction Registry. Patients were divided into 2 groups: those who received statins during hospitalization (n=280) and those who did not (n=273). The influence of statin treatment on a 12-month clinical outcome was examined using a matched-pairs analysis (n=200 in each group) based on the propensity for receiving statin therapy during hospitalization. Results: Before adjustment, patients receiving statin, compared to those not receiving statin, had a more favorable clinical profile, were less likely to suffer procedural complications, and more likely to receive adequate medical therapy. Patients receiving statin had lower unadjusted in-hospital mortality and composite rate of mortality, MI, and repeat revascularization at 12 months, which remained significantly lower after adjustment for patient risk, procedural characteristics, and treatment propensity. Conclusion: In CS patients with acute MI undergoing revascularization therapy, early statin treatment initiated during hospitalization was associated with lower rates of in-hospital death and 12-month adverse cardiac events.

Keywords

References

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