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ȣ - 520037 187 |
| Effects of statins on one-year cardiac mortality after drug-eluting stent implantation in diabetic acute myocardial infarction patients |
| 대한심장학회 Korea Acute Myocardial Infarction Registry 연구자 |
| 홍영준, 정명호, 안영근, 정해창, 채성철, 허승호, 홍택종, 김영조, 성인환, 채제건, 류제영, 채인호, 조명찬, 배장호, 나승운, 김종진, 최동훈, 장양수, 윤정한, 정욱성, 조정관, 승기배, 박승정 외 Korea Acute Myocardial Infarction Registry Investigators |
Background: Effects of statins on cardiac events in diabetic acute myocardial infarction (AMI) patients who underwent drug-eluting stent (DES) deployment remain unclear.
Objectives: The aim of this study was to evaluate the beneficial effects of statins on one-year clinical events after DES deployment in diabetic AMI patients as a substudy of Korea Acute Myocardial Infarction Registry (KAMIR).
Methods: We analyzed data of 883 consecutive diabetic AMI patients (669 ST segment elevation MI and 214 non-ST segment elevation MI) who underwent DES deployment for infarct-related arteries and survived at discharge. Statins were prescribed in 76% of the patients (672 patients). The primary end point was cardiac death, MI, and TVR at one-year.
Results: During one-year follow-up, 26 patients experienced cardiac death including 12 patients from statin group and 14 patients from control group [1.8% (12/672) vs. 6.6% (14/211), p<0.001]. There were no differences in the incidences of non-cardiac death (0.6% vs. 1.4%, p=0.238), MI (1.0% vs. 1.9%, p=0.329), and TVR (6.4% vs. 8.1%, p=0.404) between statin and control groups at one-year follow-up. Therefore, one-year MACE (including cardiac death, MI, and TVR) occurred less frequently in statin group compared with control group [51/672 (7.6%) vs. 30/211 (14.2%), p=0.004]. Compared with survivors, decedents were older (67.9±10.8 years vs. 64.3±11.0 years, p=0.005), had more multivessel disease [66/81 (81%) vs. 543/802 (68%), p=0.002], higher creatinine (1.6±1.0 mg/dl vs. 1.2±0.6 mg/dl, p=0.024), higher high-sensitivity C-reactive protein (hs-CRP) (5.2±10.2 mg/dl vs. 1.6±3.0 mg/dl, p=0.005), and higher NT-pro-BNP levels (7599±6568 pg/ml vs. 3186±3589 pg/ml, p=0.009). Multivariate analysis showed that non-use of statins, hs-CRP, and age were the independent predictors of one-year mortality [Hazard ratio (HR); 0.234, 95% CI=0.081-0.672, p=0.007, HR=1.523; 95% CI=1.271-1.823, p<0.001, HR=1.104; 95% CI=1.037-1.175, p=0.002, respectively].
Conclusions: High hs-CRP levels and old age are associated with poor prognosis, and statins could decrease mortality rate after DES deployment in diabetic AMI patients in KAMIR.
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