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ȣ - 530022 124 |
| Impact of low-density lipoprotein cholesterol and high-sensitivity C-reactive protein goal achievement on cardiac events in patients with acute myocardial infarction |
| 전남대학교병원1, 가천의대인천길병원2, 건양대학교병원3, 계명의대동산의료원4, 고려대학교구로병원5, 대구카톨릭대학교병원6, 분당서울대학교병원7, 부산수영한서병원8, 원광대학교병원9, 중앙대학교병원10; Livalo (Pitavastatin) in Acute Myocardial Infarction Study (LAMIS) Group |
| 조우리1, 홍영준1, 정명호1, 안영근1, 안태훈2, 배장호3, 허승호4, 라승운5, 김기식6, 채인호7, 김종현8, 윤경호9, 김상욱10 |
Background: There are very limited data regarding role of statin in managing acute myocardial infarction (AMI) patients.
Objectives: The aim of this study was to assess the impact of low-density lipoprotein cholesterol (LDL) (<100mg/dl) and high-sensitivity C-reactive protein (hs-CRP) goal (<0.5mg/dl) achievement on major adverse cardiac events (MACE: death, MI, target lesion revascularization) by pitavastatin therapy (initial dosage: 2mg/day, if it’s not enough to reduce LDL-C, increase up to 4mg/day) in AMI patients.
Methods: From April 2007 to May 2009, a total of 1,108 AMI patients were enrolled in Livalo in Acute Myocardial Infarction Study (LAMIS). Of these pts, 6-month follow-up was done in 631 pts and 12-month clinical follow-up was done in 353 patients.
Results: 12-month MACE occurred in 12% of the patients. 6-month follow-up LDL goal was achieved in 71% of the patients. 6-month follow-up LDL level was 92±23 mg/dl in 12-month MACE group and was 89±24 mg/dl in 12-month non-MACE group (p=0.7). There was a trend that the incidence of 12-month MACE was lower in patients with 6-month LDL goal achievement group (10% vs. 16%, p=0.18). 6-month follow-up hs-CRP goal was achieved in 61% of the patients. 6-month follow-up hs-CRP level was 6.2±24.5 mg/dl in 12-month MACE group and was 2.4±10.3 mg/dl in 12-month non-MACE group (p=0.19). There was a trend that the incidence of 12-month MACE was lower in patients with 6-month hs-CRP goal achievement group (9% vs. 17%, p=0.18). When we compared LAMIS patients with 76 patients who had not taken statins in KAMIR, the incidence of 12-month MACE was significantly lower in pitavastatin group in LAMIS (12% vs. 24%, p<0.001). Interestingly, MACE-lowering effects of pitavastatin over no statin was observed more significantly in elevated baseline hs-CRP group (>0.5mg/dl) (15% vs. 26%, p=0.039) compared with normal baseline hs-CRP group (<0.5mg/dl) (8% vs. 17%, p=0.19).
Conclusions: There were trends toward lower MACE in patients who achieved LDL and hs-CRP goals in patients who received pitavastatin. The use of pitavastatin markedly reduced MACE, especially in patients with elevated hs-CRP.
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