Statin therapy and mortality in patients with ST-segment ... - NCBI

3 downloads 0 Views 1MB Size Report
Background. Statin therapy can reduce long-term mortality in several subgroups of patients with coronary artery disease, but the benefits after.
ORIGINAL ARTICLE

Statin therapy and mortality in patients with ST-segment elevation myocardial

infarction treated with primary angioplasty G. De Luca, H. Suryapranata, F. Zijlstra, J.P. Ottervanger, A.W.J. van 't Hof, J.C.A. Hoorntje, A.T.M. Gosselink, J-H.E. Dambrink, M-J. de Boer

Background. Statin therapy can reduce long-term mortality in several subgroups of patients with coronary artery disease, but the benefits after primary angioplasty for ST-segment elevation myocardial infarction (STEMI) have yet to be established. Thus the aim of the current study was to determine whether statin therapy is associated with a reduction in mortality in patients with STEMI treated with primary angioplasty. Methods. Our population is represented by a total of 1513 consecutive in-hospital survivors treated with primary angioplasty for STEMI between April 1997 and October 2001. Patients were divided into two groups according to statin therapy (statin group, n=893; control group, n=620) at discharge. Clinical follow-up was performed at one year. Multivariate analysis was performed incuding a propensity score for statin use. Results. At one-year follow-up statin therapy was associated with a significantly lower mortality (1.2 vs. 7.1%, RR [95% CI] 0.16 [0.09-0.32], p1 Anterior infarction Age >65 years Hypertension Beta-blockers Multivessel disease Diabetes Propensity score IABP

Relative risk [95%CI]

p value

0.24 [0.12-0.47] 2.69 [1.45-4.98] 2.24 [1.30-3.84] 2.18 [1.13-4.18] 1.92 [1.07-3.43] 1.90 [1.07-3.36] 1.68 [0.95-2.96] 0.61 [0.32-1.19] 1.42 [0.78-2.61] 1.49 [0.73-3.03] 1.15 [0.81-1.62] 1.13 [0.53-2.43]