Statin Therapy and Intensity: Prognosis in Patients with Myocardial Injury - 20/12/21
, Andreas Roos, MD, PhD a, b, Anwar J. Siddiqui, MD, PhD a, b, Ulrik Sartipy, MD, PhD c, d, Martin J. Holzmann, MD, PhD a, b, ⁎Abstract |
Background |
No guideline-directed pharmacological therapy has been established for patients with myocardial injury without type 1 myocardial infarction. We investigated the impact of statin treatment in patients with myocardial injury.
Methods |
Patients with myocardial injury (nonischemic acute and chronic myocardial injury), type 2 myocardial infarction, and type 1 myocardial infarction with at least 1 emergency department visit for chest pain from 2011 to 2014 were included. Dispensed prescriptions of all types of statins with dosage within 180 days from the index visit were collected. In total, 2054 patients were divided into 3 groups: 1) acute myocardial injury (type 2 myocardial infarction, acute nonischemic myocardial injury), 2) chronic myocardial injury, and 3) type 1 myocardial infarction. We estimated the adjusted hazard ratio with 95% confidence interval for death with low- (reference), moderate-, and high-intensity statin therapy.
Results |
The mean follow-up was 4.2 ± 1.8 years. Only 13% of patients with acute and chronic myocardial injury and 30% with type 1 myocardial infarction were treated with high-intensity statins. Adjusted mortality rates were higher in patients with acute and chronic myocardial injury than in those with type 1 myocardial infarction across all statin intensity categories. In patients with type 1 myocardial infarction, the adjusted mortality risk was 20% (hazard ratio, 0.80; 95% confidence interval, 0.36-1.77) lower in patients with high-intensity therapy. Point estimates in the adjusted models indicated similar associations between statin intensity and mortality risk in patients with acute and chronic myocardial injury.
Conclusion |
Patients with myocardial injury may benefit from high-intensity statin treatment, but the associations were not statistically significant when adjusting for confounders.
Le texte complet de cet article est disponible en PDF.Keywords : Cardiac biomarker, Myocardial infarction, Myocardial injury, Statin, Troponin
Plan
| Funding: No specific funding was obtained for this study. EK holds a research position funded by the regional agreement on medical training and clinical research between Stockholm County Council and the Karolinska Institute (Grant number: 20190354). AR holds a research position funded by the Stockholm County Council (Grant number: 20200935). US is supported by the Swedish Heart-Lung Foundation (Grant numbers 20180400 and 20190533). MJH holds research positions funded by the Swedish Heart-Lung Foundation (Grant number: 20170804) and the Stockholm County Council (Grant number: 20170686). The sponsors had no role in the design or conduct of this study. |
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| Conflicts of Interest: MJH reports consultancy honoraria from Idorsia. EK, AR, AJS, US report none. |
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| Authorship: All authors had access to the data and a role in writing this manuscript. |
Vol 134 - N° 12
P. 1522 - décembre 2021 Retour au numéro
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