European Heart Journal Advance Access originally published online on July 4, 2006
European Heart Journal 2006 27(15):1799-1804; doi:10.1093/eurheartj/ehl125
| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
Patients using statin treatment within 24 h after admission for ST-elevation acute coronary syndromes had lower mortality than non-users: a report from the first Euro Heart Survey on acute coronary syndromes
1 Atrium Medical Centre, Heerlen, The Netherlands
2 Department of Cardiology, Thoraxcentre, Erasmus University Medical Center, Room H560, Dr Molewaterplein 40, 3015 GD Rotterdam, Rotterdam, The Netherlands
3 Klinikum der Stadt Ludwigshafen Germany
4 University of Uppsala, Uppsala, Sweden
5 Gasthuisberg University Hospital, Leuven, Belgium
6 Rabin Medical Center, Petah Tikwa, Israel
7 Neufeld Cardiac Research Institute, Tel Hashomer, Israel
Received 27 September 2005; revised 28 April 2006; accepted 1 June 2006; online publish-ahead-of-print 4 July 2006.
* Corresponding author. Tel: +31 10 4633938; fax: +31 10 4635258. E-mail address: m.simoons{at}erasmusmc.nl
Aims Statins provide effective secondary prevention in cardiovascular disease. However, it remains uncertain how soon statins should be started after an acute coronary syndrome (ACS). Recently published trials suggest starting before discharge. We hypothesize that statins should be initiated without delay.
Methods and results Data from a large cohort of 10 484 consecutive patients with an ACS were analysed. Of this cohort, 1426 first-time statin receivers and survivors of the first 24 h were compared with 6771 first-day survivors not receiving statin therapy. A propensity score for the likelihood of receiving statin therapy within 24 h was developed and used with other established risk factors in a multivariable analysis. There was a significantly reduced all-cause 7-day mortality in patients receiving early statin therapy [0.4 vs. 2.6%, unadjusted hazard ratio (HR) 0.16, 95% confidence interval (CI) 0.08–0.37, adjusted HR 0.34, 95% CI 0.15–0.79]. Statistical significance was observed in patients presenting with STE-ACS (adjusted HR 0.17, 95% CI 0.04–0.70) and not in NSTE-ACS patients. However, no statistical evidence of heterogeneity in treatment effect was observed between these groups.
Conclusion These data suggest that very early statin therapy is associated with reduced mortality in patients presenting with STE-ACS; however, these findings have to be confirmed by prospective, randomized controlled trials before firm treatment recommendations can be given.
Key Words: Statin • Acute coronary syndrome • Mortality • Prevention
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  M. Thielmann, M. Neuhauser, A. Marr, B. R. Jaeger, D. Wendt, B. Schuetze, M. Kamler, P. Massoudy, R. Erbel, and H. Jakob Lipid-lowering effect of preoperative statin therapy on postoperative major adverse cardiac events after coronary artery bypass surgery. J. Thorac. Cardiovasc. Surg., November 1, 2007; 134(5): 1143 - 1149. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Vlachopoulos, K. Aznaouridis, A. Dagre, C. Vasiliadou, C. Masoura, E. Stefanadi, J. Skoumas, C. Pitsavos, and C. Stefanadis Protective effect of atorvastatin on acute systemic inflammation-induced endothelial dysfunction in hypercholesterolaemic subjects Eur. Heart J., September 1, 2007; 28(17): 2102 - 2109. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. Ahmed, F. Zannad, T. E. Love, J. Tallaj, M. Gheorghiade, O. J. Ekundayo, and B. Pitt A propensity-matched study of the association of low serum potassium levels and mortality in chronic heart failure Eur. Heart J., June 1, 2007; 28(11): 1334 - 1343. [Abstract] [Full Text] [PDF]
|
|