Association of Contemporary Statin Pretreatment Intensity and LDL-C Levels on the Incidence of STEMI Presentation

被引:1
作者
Dadon, Ziv [1 ]
Moriel, Mady [1 ]
Iakobishvili, Zaza [2 ,3 ]
Asher, Elad [1 ,4 ]
Samuel, Tal Y. [1 ]
Gavish, Dov [1 ,3 ]
Glikson, Michael [1 ,4 ]
Gottlieb, Shmuel [1 ,3 ]
机构
[1] Shaare Zedek Med Ctr, Jesselson Integrated Heart Ctr, IL-9103102 Jerusalem, Israel
[2] Clalit Hlth Serv, IL-6209804 Tel Aviv, Israel
[3] Tel Aviv Univ, Sackler Fac Med, IL-69978 Tel Aviv, Israel
[4] Hebrew Univ Jerusalem, Fac Med, Campus Kerem, IL-9112102 Jerusalem, Israel
来源
LIFE-BASEL | 2021年 / 11卷 / 11期
关键词
acute coronary syndrome; low-density lipoprotein cholesterol; myocardial infarction; primary prevention; secondary prevention; statin; ACUTE CORONARY SYNDROMES; LIPID-LOWERING THERAPY; ELEVATION MYOCARDIAL-INFARCTION; OPTICAL COHERENCE TOMOGRAPHY; FIBROUS CAP; CHOLESTEROL; PLAQUE; ATHEROSCLEROSIS; PROGRESSION; OUTCOMES;
D O I
10.3390/life11111268
中图分类号
Q [生物科学];
学科分类号
07 ; 0710 ; 09 ;
摘要
Constituting hypolipidemic and pleiotropic effects, statins stabilize coronary artery plaque and may prevent STEMI events. This study investigated the association between contemporary statin pretreatment intensity, low-density lipoprotein cholesterol (LDL-C) levels, and the type of acute coronary syndrome (ACS) presentation: STEMI vs. NSTE-ACS. Data were drawn from the ACS Israeli Survey (ACSIS), a biennial prospective national survey that took place in 2008-2018. The rate of STEMI vs. NSTE-ACS was calculated by statin use, including statin intensity (high-intensity statin therapy (HIST) and low-intensity statin therapy (LIST) prior to the index ACS event. Among 5103 patients, 2839 (56%) were statin-naive, 1389 (27%) used LIST and 875 (17%) used HIST. Statin pretreated patients were older and had a higher rates of co-morbidities, cardiovascular disease history and pretreatment with evidence-based medications. STEMI vs. NSTE-ACS was lower among HIST vs. LIST vs. statin-naive patients (31.0%, 37.8%, and 54.0%, respectively, p for trend < 0.001). Multivariate analysis revealed that HIST was independently associated with lower STEMI presentation (ORadj 0.70; 95% CI 0.57-0.86), while LIST (ORadj 0.92; 95% CI 0.77-1.10) and LDL-C < 70 mg/dL (ORadj 0.96; 95% CI 0.82-1.14) were not. In conclusion, among patients admitted with ACS, pretreatment with HIST was independently associated with a lower probability of STEMI presentation, while LIST and LDL-C < 70 mg/dL were not.
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页数:11
相关论文
共 30 条
[1]   Effects of intensive lipid-lowering therapy on coronary plaques composition in patients with acute myocardial infarction: Assessment with serial coronary CT angiography [J].
Auscher, Soren ;
Heinsen, Laurits ;
Nieman, Koen ;
Vinther, Kristina Hoeg ;
Logstrup, Brian ;
Moller, Jacob Eifer ;
Broersen, Alexander ;
Kitslaar, Pieter ;
Lambrechtsen, Jess ;
Egstrup, Kenneth .
ATHEROSCLEROSIS, 2015, 241 (02) :579-587
[2]  
Björck L, 2010, ARCH INTERN MED, V170, P1375, DOI 10.1001/archinternmed.2010.203
[3]   Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) expert panel on detection, evaluation, and treatment of high blood cholesterol in adults (Adult Treatment Panel III) [J].
Cleeman, JI ;
Grundy, SM ;
Becker, D ;
Clark, LT ;
Cooper, RS ;
Denke, MA ;
Howard, WJ ;
Hunninghake, DB ;
Illingworth, DR ;
Luepker, RV ;
McBride, P ;
McKenney, JM ;
Pasternak, RC ;
Stone, NJ ;
Van Horn, L ;
Brewer, HB ;
Ernst, ND ;
Gordon, D ;
Levy, D ;
Rifkind, B ;
Rossouw, JE ;
Savage, P ;
Haffner, SM ;
Orloff, DG ;
Proschan, MA ;
Schwartz, JS ;
Sempos, CT ;
Shero, ST ;
Murray, EZ .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2001, 285 (19) :2486-2497
[4]   The impact of statin treatment on presentation mode and early outcomes in acute coronary syndromes [J].
Cuculi, F. ;
Radovanovic, D. ;
Eberli, F. R. ;
Stauffer, J. C. ;
Bertel, O. ;
Erne, P. .
CARDIOLOGY, 2008, 109 (03) :156-162
[5]   Beneficial cardiovascular pleiotropic effects of statins [J].
Davignon, J .
CIRCULATION, 2004, 109 (23) :39-43
[6]   Inflammatory markers and cardiac function in acute coronary syndrome: Difference in ST-segment elevation myocardial infarction (STEMI) and in non-STEMI models [J].
Di Stefano, Rossella ;
Di Bello, Vitantonio ;
Barsotti, Maria Chiara ;
Grigoratos, Chrysanthos ;
Armani, Chiara ;
Dell'Omodarme, Matteo ;
Carpi, Angelo ;
Balbarini, Alberto .
BIOMEDICINE & PHARMACOTHERAPY, 2009, 63 (10) :773-780
[7]   Effects of statins on plaque rupture assessed by optical coherence tomography in patients presenting with acute coronary syndromes: insights from the optical coherence tomography (OCT)-FORMIDABLE registry [J].
Gili, Sebastiano ;
Iannaccone, Mario ;
Colombo, Francesco ;
Montefusco, Antonio ;
Amabile, Nicolas ;
Calcagno, Simone ;
Capodanno, Davide ;
Scalone, Giancarla ;
Rognoni, Andrea ;
Omede, Pierluigi ;
Ugo, Fabrizio ;
Cavallo, Erika ;
Mancone, Massimo ;
Mangiameli, Andrea ;
Boccuzzi, Giacomo ;
Hiansen, Joshua ;
Motreff, Pascal ;
Toutouzas, Konstantinos ;
Garbo, Roberto ;
Sardella, Gennaro ;
Tamburino, Corrado ;
D'Amico, Maurizio ;
Moretti, Claudio ;
Templin, Christian ;
Gaita, Fiorenzo ;
Souteyrand, Geraud ;
Niccoli, Giampaolo ;
D'Ascenzo, Fabrizio .
EUROPEAN HEART JOURNAL-CARDIOVASCULAR IMAGING, 2018, 19 (05) :524-531
[8]   Association between statin treatment and LDL-cholesterol levels on the rate of ST-elevation myocardial infarction among patients with acute coronary syndromes: ACS Israeli Survey (ACSIS) 2002-2010 [J].
Gottlieb, Shmuel ;
Kolker, Shimon ;
Shlomo, Nir ;
Matetzky, Shlomi ;
Leitersdorf, Eran ;
Segev, Amit ;
Goldenberg, Ilan ;
Tzivoni, Dan ;
Weisz, Giora ;
Moriel, Mady .
INTERNATIONAL JOURNAL OF CARDIOLOGY, 2016, 210 :133-138
[9]  
Grundy S.M., 2018
[10]   CAC-DRS: Coronary Artery Calcium Data and Reporting System. An expert consensus document of the Society of Cardiovascular Computed Tomography (SCCT) [J].
Hecht, Harvey S. ;
Blaha, Michael J. ;
Kazerooni, Ella A. ;
Cury, Ricardo C. ;
Budoff, Matt ;
Leipsic, Jonathon ;
Shaw, Leslee .
JOURNAL OF CARDIOVASCULAR COMPUTED TOMOGRAPHY, 2018, 12 (03) :185-191