Clinical Benefit of Statins in Korean Patients with Acute Myocardial Infarction: Experience of the Korea Acute Myocardial Infarction Registry.
Kyung Hoon ChoYoungkeun AhnPublished in: Journal of lipid and atherosclerosis (2020)
Statins (3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitor) are among the most important medications for treating patients with acute myocardial infarction (AMI). Herein, we review the clinical benefit and future scope of statin therapy in Korean patients with AMI from the experience of the Korea AMI Registry. Statins are effective and safe in AMI patients, even in those with very low low-density lipoprotein cholesterol (LDL-C). Peri-procedural statin treatment could reduce the incidence of early stent thrombosis in patients with AMI after percutaneous coronary intervention. Reduction of high sensitivity C-reactive protein levels in patients with AMI plays an important role in the beneficial effect of statins on regression and compositional change of coronary plaques. Obtaining ≥50% reduction in LDL-C is associated with better clinical outcomes after AMI, whereas achieving <70 mg/dL LDL-C is not. Statin therapy has positive effects on clinical outcomes in patients with cardiogenic shock, ischemic heart failure, chronic kidney disease, and vasospasm. The combination of high-dose statin plus N-acetyl cysteine is associated with lower incidence of contrast-induced nephropathy in patients who underwent primary percutaneous coronary intervention. Moderate-intensity pitavastatin therapy is associated with a lower incidence of new-onset diabetes mellitus in patients with AMI and has similar clinical outcomes to moderate-intensity atorvastatin and rosuvastatin therapy. Future studies are required to assess the optimal intensity and LDL-C target concerning statin therapy, and the implementation of guidelines based cholesterol lowering practice in Korean patients with AMI.
Keyphrases
- acute myocardial infarction
- percutaneous coronary intervention
- coronary artery disease
- cardiovascular disease
- end stage renal disease
- low density lipoprotein
- chronic kidney disease
- st segment elevation myocardial infarction
- left ventricular
- acute coronary syndrome
- st elevation myocardial infarction
- antiplatelet therapy
- heart failure
- coronary artery bypass grafting
- high intensity
- ejection fraction
- high dose
- newly diagnosed
- peritoneal dialysis
- atrial fibrillation
- current status
- primary care
- oxidative stress
- subarachnoid hemorrhage
- prognostic factors
- coronary artery
- low dose
- magnetic resonance
- risk factors
- patient reported
- stem cells
- patient reported outcomes
- weight loss
- coronary artery bypass
- mesenchymal stem cells
- drug induced
- pulmonary embolism
- endothelial cells
- blood brain barrier
- replacement therapy
- fluorescent probe
- single molecule