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| Pitavastatin (Livalo®) versus No Statin in Patients with Acute Myocardial Infarction Undergoing Percutaneous Coronary Intervention
: 12-month Clinical Outcomes from Livalo Acute Myocardial Infarction Study (LAMIS)
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| 고려대학교 구로병원 순환기내과¹, 전남대학교 병원 심장센터², 가천의대 심장센터³, 건양의대 심장내과⁴, 계명의대 동산의료원 심장내과5, 분당서울대병원 심장내과6, 수영한서병원 심장혈관센터7, 원광의대 순환기내과8, 중앙대학교병원 순환기내과9, 대구가톨릭대학교병원 순환기내과10. |
| 나승운, Lin Wang¹, 박지영¹, Kanhaiya L. Poddar¹, 최병걸¹, 김지박¹, 신승용¹, 최운정¹, 최철웅¹, 임홍의¹, 김진원¹, 김응주¹, 박창규¹, 서홍석¹, 오동주¹, 정명호², 안영근², 홍영준 2, 안태훈 3, 배장호 4, 허승호 5, 채인호 6, 김종현 7, 윤경호 8, 김상욱 9, 김기식 10 (LAMIS Investigators) |
Background： Pitavastatin (Livalo) is a potent lipophilic statin and may play an important role in acute myocardial infarction (AMI) setting but there have been limited data regarding role of pitavastatin in managing AMI patients (pts), especially in the drug-eluting stent era. Method: The study originated from the Livalo AMI study (LAMIS), which exclusively used Pitavastatin (2mg/day as sole statin therapy from the presentation time) and from the Korea AMI Registry (KAMIR) enrolled from April 2007 to March 25, 2009 as a historical comparison data. We compared the clinical outcomes using propensity score adjustment between the STEMI pts treated with Pitavastatin (n=601) and without statin treatment from KAMIR (n=468) up to 12 months.Results: The baseline characteristics were similar between the two groups, except that pts in Livalo group were younger (61.2±12.0 vs 63.0±12, p<0.05) and showed higher total cholesterol level (194.9±41.3 vs 174.5±42.2, mg/dl, p<0.01) than no statin group. Although the incidence of recurrent AMI was similar between the groups, the incidence of mortality, repeat PCI and MACE were significantly lower in the Pitavastatin group (Table). Pitavastatin administration was associated with less incidence of MACE at 12 months (ORunadjusted: 0.560, 95% CI: 0.360-0.873, P=0.010, ORadjusted by propensity score: 0.200, 95% CI: 0.065-0.613, P= 0.005).Conclusion: Routine administration of 2mg Pitavastatin daily in AMI pts showed better clinical outcomes compared with those of AMI pts without statin therapy up to 12 months.
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Table. Clinical Outcomes at 12-month
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Variables, N (%) |
No Statin
(N=468) |
Pitavastatin
(N=601) |
P-value |
|
Total Death |
10(2.6) |
4(0.7) |
0.036 |
|
Cardiac Death |
8(1.7) |
2(0.3) |
0.020 |
|
Repeat PCI |
36(7.7) |
28(4.7) |
0.038 |
|
TLR |
12(2.6) |
19(3.2) |
0.564 |
|
TVR |
15(3.2) |
20(3.3) |
0.911 |
|
Non-TVR |
19(4.1) |
8(1.3) |
0.005 |
|
Recurrent AMI |
0(0) |
3(0.5) |
0.261 |
|
CABG |
0(0) |
1(0.2) |
0.562 |
|
Total MACE |
46(9.8) |
34(5.7)* |
0.010 |
* 2 patients underwent PCI due to recurrent AMI
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