Efficacy of Statin Treatment According to Baseline Renal Function in Korean Patients with Acute Myocardial Infarction Not Requiring Dialysis Undergoing Newer-Generation Drug-Eluting Stent Implantation
We investigated the 2-year efficacy of statin treatment according to baseline renal function in patients with acute myocardial infarction (AMI) not requiring dialysis undergoing newer-generation drug-eluting stent (DES) implantation. A total of 18,875 AMI patients were classified into group A (stati...
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MDPI AG
2021-08-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/16/3504 |
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| author | Yong Hoon Kim Ae-Young Her Myung Ho Jeong Byeong-Keuk Kim Sung-Jin Hong Seunghwan Kim Chul-Min Ahn Jung-Sun Kim Young-Guk Ko Donghoon Choi Myeong-Ki Hong Yangsoo Jang |
| author_facet | Yong Hoon Kim Ae-Young Her Myung Ho Jeong Byeong-Keuk Kim Sung-Jin Hong Seunghwan Kim Chul-Min Ahn Jung-Sun Kim Young-Guk Ko Donghoon Choi Myeong-Ki Hong Yangsoo Jang |
| author_sort | Yong Hoon Kim |
| collection | DOAJ |
| description | We investigated the 2-year efficacy of statin treatment according to baseline renal function in patients with acute myocardial infarction (AMI) not requiring dialysis undergoing newer-generation drug-eluting stent (DES) implantation. A total of 18,875 AMI patients were classified into group A (statin users, <i>n</i> = 16,055) and group B (statin nonusers, <i>n</i> = 2820). According to the baseline estimated glomerular filtration rate (eGFR; ≥90, 60–89, 30–59 and <30 mL/min/1.73 m<sup>2</sup>), these two groups were sub-classified into groups A1, A2, A3 and A4 and groups B1, B2, B3 and B4. The major adverse cardiac events (MACE), defined as all-cause death, recurrent MI (re-MI) and any repeat revascularization, were evaluated. The MACE (group A1 vs. B1, <i>p</i> = 0.002; group A2 vs. B2, <i>p</i> = 0.007; group A3 vs. B3, <i>p</i> < 0.001; group A4 vs. B4, <i>p</i> < 0.001), all-cause death (<i>p</i> = 0.006, <i>p</i> < 0.001, <i>p</i> < 0.001, <i>p</i> < 0.001, respectively) and cardiac death (<i>p</i> = 0.004, <i>p</i> < 0.001, <i>p</i> < 0.001, <i>p</i> < 0.001, respectively) rates were significantly higher in statin nonusers than those in statin users. Despite the beneficial effects of statin treatment, the MACE (group A1 vs. A2 vs. A3 vs. A4: 5.2%, 6.4%, 10.1% and 18.5%, respectively), all-cause mortality (0.9%, 1.8%, 4.6% and 12.9%, respectively) and cardiac death (0.4%, 1.0%, 2.6% and 6.8%, respectively) rates were significantly increased as eGFR decreased in group A. These results may be related to the peculiar characteristics of chronic kidney disease, including increased vascular calcification and traditional or nontraditional cardiovascular risk factors. In the era of newer-generation DESs, although statin treatment was effective in reducing mortality, this beneficial effect was diminished in accordance with the deterioration of baseline renal function. |
| first_indexed | 2024-03-10T08:42:36Z |
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| id | doaj.art-18fb1c64a5104134b041611140fc9ed3 |
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| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-10T08:42:36Z |
| publishDate | 2021-08-01 |
| publisher | MDPI AG |
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| series | Journal of Clinical Medicine |
| spelling | doaj.art-18fb1c64a5104134b041611140fc9ed32023-11-22T08:09:15ZengMDPI AGJournal of Clinical Medicine2077-03832021-08-011016350410.3390/jcm10163504Efficacy of Statin Treatment According to Baseline Renal Function in Korean Patients with Acute Myocardial Infarction Not Requiring Dialysis Undergoing Newer-Generation Drug-Eluting Stent ImplantationYong Hoon Kim0Ae-Young Her1Myung Ho Jeong2Byeong-Keuk Kim3Sung-Jin Hong4Seunghwan Kim5Chul-Min Ahn6Jung-Sun Kim7Young-Guk Ko8Donghoon Choi9Myeong-Ki Hong10Yangsoo Jang11Division of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon 24289, KoreaDivision of Cardiology, Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon 24289, KoreaDepartment of Cardiology, Cardiovascular Center, Chonnam National University Hospital, Gwangju 61469, KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDivision of Cardiology, Inje University College of Medicine, Haeundae Paik Hospital, Busan 48108, KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaDivision of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul 03722, KoreaWe investigated the 2-year efficacy of statin treatment according to baseline renal function in patients with acute myocardial infarction (AMI) not requiring dialysis undergoing newer-generation drug-eluting stent (DES) implantation. A total of 18,875 AMI patients were classified into group A (statin users, <i>n</i> = 16,055) and group B (statin nonusers, <i>n</i> = 2820). According to the baseline estimated glomerular filtration rate (eGFR; ≥90, 60–89, 30–59 and <30 mL/min/1.73 m<sup>2</sup>), these two groups were sub-classified into groups A1, A2, A3 and A4 and groups B1, B2, B3 and B4. The major adverse cardiac events (MACE), defined as all-cause death, recurrent MI (re-MI) and any repeat revascularization, were evaluated. The MACE (group A1 vs. B1, <i>p</i> = 0.002; group A2 vs. B2, <i>p</i> = 0.007; group A3 vs. B3, <i>p</i> < 0.001; group A4 vs. B4, <i>p</i> < 0.001), all-cause death (<i>p</i> = 0.006, <i>p</i> < 0.001, <i>p</i> < 0.001, <i>p</i> < 0.001, respectively) and cardiac death (<i>p</i> = 0.004, <i>p</i> < 0.001, <i>p</i> < 0.001, <i>p</i> < 0.001, respectively) rates were significantly higher in statin nonusers than those in statin users. Despite the beneficial effects of statin treatment, the MACE (group A1 vs. A2 vs. A3 vs. A4: 5.2%, 6.4%, 10.1% and 18.5%, respectively), all-cause mortality (0.9%, 1.8%, 4.6% and 12.9%, respectively) and cardiac death (0.4%, 1.0%, 2.6% and 6.8%, respectively) rates were significantly increased as eGFR decreased in group A. These results may be related to the peculiar characteristics of chronic kidney disease, including increased vascular calcification and traditional or nontraditional cardiovascular risk factors. In the era of newer-generation DESs, although statin treatment was effective in reducing mortality, this beneficial effect was diminished in accordance with the deterioration of baseline renal function.https://www.mdpi.com/2077-0383/10/16/3504statinmyocardial infarctionrenal function |
| spellingShingle | Yong Hoon Kim Ae-Young Her Myung Ho Jeong Byeong-Keuk Kim Sung-Jin Hong Seunghwan Kim Chul-Min Ahn Jung-Sun Kim Young-Guk Ko Donghoon Choi Myeong-Ki Hong Yangsoo Jang Efficacy of Statin Treatment According to Baseline Renal Function in Korean Patients with Acute Myocardial Infarction Not Requiring Dialysis Undergoing Newer-Generation Drug-Eluting Stent Implantation Journal of Clinical Medicine statin myocardial infarction renal function |
| title | Efficacy of Statin Treatment According to Baseline Renal Function in Korean Patients with Acute Myocardial Infarction Not Requiring Dialysis Undergoing Newer-Generation Drug-Eluting Stent Implantation |
| title_full | Efficacy of Statin Treatment According to Baseline Renal Function in Korean Patients with Acute Myocardial Infarction Not Requiring Dialysis Undergoing Newer-Generation Drug-Eluting Stent Implantation |
| title_fullStr | Efficacy of Statin Treatment According to Baseline Renal Function in Korean Patients with Acute Myocardial Infarction Not Requiring Dialysis Undergoing Newer-Generation Drug-Eluting Stent Implantation |
| title_full_unstemmed | Efficacy of Statin Treatment According to Baseline Renal Function in Korean Patients with Acute Myocardial Infarction Not Requiring Dialysis Undergoing Newer-Generation Drug-Eluting Stent Implantation |
| title_short | Efficacy of Statin Treatment According to Baseline Renal Function in Korean Patients with Acute Myocardial Infarction Not Requiring Dialysis Undergoing Newer-Generation Drug-Eluting Stent Implantation |
| title_sort | efficacy of statin treatment according to baseline renal function in korean patients with acute myocardial infarction not requiring dialysis undergoing newer generation drug eluting stent implantation |
| topic | statin myocardial infarction renal function |
| url | https://www.mdpi.com/2077-0383/10/16/3504 |
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