Association of Contemporary Statin Pretreatment Intensity and LDL-C Levels on the Incidence of STEMI Presentation
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 sy...
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-11-01
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| Series: | Life |
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| Online Access: | https://www.mdpi.com/2075-1729/11/11/1268 |
| _version_ | 1797509631184994304 |
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| author | Ziv Dadon Mady Moriel Zaza Iakobishvili Elad Asher Tal Y. Samuel Dov Gavish Michael Glikson Shmuel Gottlieb |
| author_facet | Ziv Dadon Mady Moriel Zaza Iakobishvili Elad Asher Tal Y. Samuel Dov Gavish Michael Glikson Shmuel Gottlieb |
| author_sort | Ziv Dadon |
| collection | DOAJ |
| description | 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, <i>p</i> for trend < 0.001). Multivariate analysis revealed that HIST was independently associated with lower STEMI presentation (OR<sub>adj</sub> 0.70; 95% CI 0.57–0.86), while LIST (OR<sub>adj</sub> 0.92; 95% CI 0.77–1.10) and LDL-C < 70 mg/dL (OR<sub>adj</sub> 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. |
| first_indexed | 2024-03-10T05:20:29Z |
| format | Article |
| id | doaj.art-2c3ebdb2d8a1488c81ac125159b13bbc |
| institution | Directory Open Access Journal |
| issn | 2075-1729 |
| language | English |
| last_indexed | 2024-03-10T05:20:29Z |
| publishDate | 2021-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Life |
| spelling | doaj.art-2c3ebdb2d8a1488c81ac125159b13bbc2023-11-23T00:05:23ZengMDPI AGLife2075-17292021-11-011111126810.3390/life11111268Association of Contemporary Statin Pretreatment Intensity and LDL-C Levels on the Incidence of STEMI PresentationZiv Dadon0Mady Moriel1Zaza Iakobishvili2Elad Asher3Tal Y. Samuel4Dov Gavish5Michael Glikson6Shmuel Gottlieb7Jesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem 9103102, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem 9103102, Israel“Clalit” Health Services, Tel-Aviv District, Tel Aviv-Yafo 6209804, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem 9103102, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem 9103102, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem 9103102, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem 9103102, IsraelJesselson Integrated Heart Center, Shaare Zedek Medical Center, Jerusalem 9103102, IsraelConstituting 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, <i>p</i> for trend < 0.001). Multivariate analysis revealed that HIST was independently associated with lower STEMI presentation (OR<sub>adj</sub> 0.70; 95% CI 0.57–0.86), while LIST (OR<sub>adj</sub> 0.92; 95% CI 0.77–1.10) and LDL-C < 70 mg/dL (OR<sub>adj</sub> 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.https://www.mdpi.com/2075-1729/11/11/1268acute coronary syndromelow-density lipoprotein cholesterolmyocardial infarctionprimary preventionsecondary preventionstatin |
| spellingShingle | Ziv Dadon Mady Moriel Zaza Iakobishvili Elad Asher Tal Y. Samuel Dov Gavish Michael Glikson Shmuel Gottlieb Association of Contemporary Statin Pretreatment Intensity and LDL-C Levels on the Incidence of STEMI Presentation Life acute coronary syndrome low-density lipoprotein cholesterol myocardial infarction primary prevention secondary prevention statin |
| title | Association of Contemporary Statin Pretreatment Intensity and LDL-C Levels on the Incidence of STEMI Presentation |
| title_full | Association of Contemporary Statin Pretreatment Intensity and LDL-C Levels on the Incidence of STEMI Presentation |
| title_fullStr | Association of Contemporary Statin Pretreatment Intensity and LDL-C Levels on the Incidence of STEMI Presentation |
| title_full_unstemmed | Association of Contemporary Statin Pretreatment Intensity and LDL-C Levels on the Incidence of STEMI Presentation |
| title_short | Association of Contemporary Statin Pretreatment Intensity and LDL-C Levels on the Incidence of STEMI Presentation |
| title_sort | association of contemporary statin pretreatment intensity and ldl c levels on the incidence of stemi presentation |
| topic | acute coronary syndrome low-density lipoprotein cholesterol myocardial infarction primary prevention secondary prevention statin |
| url | https://www.mdpi.com/2075-1729/11/11/1268 |
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