The Effect of Early, Intensive Statin Therapy on Acute Coronary Syndrome

Hulten, Edward; Jackson, Jeffrey L.; Douglas, Kevin; George, Sam; Villines, Todd C.

doi:10.1001/archinte.166.17.1814

Cited by 180 publications

(106 citation statements)

References 46 publications

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“…However, patients on BB were more often prescribed statins and clopidogrel. Statins reduce cardiovascular events and improve mortality post‐MI on the short term and long term 11, 12. In a recent analysis of the French registry of FAST‐MI (Acute ST‐ and Non‐ST‐Elevation Myocardial Infarction),13 statins were associated with decreased mortality post‐MI, even after 5 years from the event.…”

Section: Discussionmentioning

confidence: 99%

β‐Blocker Therapy Prior to Admission for Acute Coronary Syndrome in Patients Without Heart Failure or Left Ventricular Dysfunction Improves In‐Hospital and 12‐Month Outcome: Results From the GULF‐RACE 2 (Gulf Registry of Acute Coronary Events‐2)

Khalil

AlHabib

Singh

et al. 2017

JAHA

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BackgroundThe prognostic impact of β‐blockers (BB) in acute coronary syndrome (ACS) patients without heart failure (HF) or left ventricular dysfunction is controversial, especially in the postreperfusion era. We sought to determine whether a BB therapy before admission for ACS has a favorable in‐hospital outcome in patients without HF, and whether they also reduce 12‐month mortality if still prescribed on discharge.Methods and ResultsThe GULF‐RACE 2 (Gulf Registry of Acute Coronary Events‐2) is a prospective multicenter study of ACS in 6 Middle Eastern countries. We studied in‐hospital cardiovascular events in patients hospitalized for ACS without HF in relation to BB on admission, and 1‐year mortality in relation to BB on discharge. Among the 7903 participants, 7407 did not have HF, of whom 5937 (80.15%) patients were on BB. Patients on BB tended to be older and have more comorbidities. However, they had a lower risk of in‐hospital mortality, mitral regurgitation, HF, cardiogenic shock, and ventricular tachycardia/ventricular fibrillation. Furthermore, 4208 patients were discharged alive and had an ejection fraction ≥40%. Among those, 84.1% had a BB prescription. At 12 months, they also had a reduced risk of mortality as compared with the non‐BB group. Even after correcting for confounding factors in 2 different models, in‐hospital and 12‐month mortality risk was still lower in the BB group.ConclusionsIn this cohort of ACS, BB therapy before admission for ACS is associated with decreased in‐hospital mortality and major cardiovascular events, and 1‐year mortality in patients without HF or left ventricular dysfunction if still prescribed on discharge.

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Section: Discussionmentioning

confidence: 99%

β‐Blocker Therapy Prior to Admission for Acute Coronary Syndrome in Patients Without Heart Failure or Left Ventricular Dysfunction Improves In‐Hospital and 12‐Month Outcome: Results From the GULF‐RACE 2 (Gulf Registry of Acute Coronary Events‐2)

Khalil

AlHabib

Singh

et al. 2017

JAHA

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“…Nevertheless, the effect of other cotreatment strategies such as a higher use of acetylsalicylic acid, statins or angiotensin -converting enzyme inhibitors could have favoured better outcomes in this group, although one would not expect that it would largely explain the difference in very short-term in-hospital outcomes. A recent meta-analysis by Hulten et al (20) showed no impact on cardiovascular events at one month of early intensive statin therapy for acute coronary syndromes. The benefits of intensive statin therapy appeared four to six months after the initial event.…”

Section: Limitationsmentioning

confidence: 99%

Effectiveness of a change in reperfusion strategy to primary percutaneous coronary intervention in a nonselected population

Matteau

Dorais

Rinfret

et al. 2009

Canadian Journal of Cardiology

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“…Statine reduzieren das Auftreten wesentlicher unerwünschter kardiovaskulärer Ereignisse (MACE), wenn sie früh in den ersten Tagen nach Beginn eines ACS gegeben werden [181,182] …”

Section: Lipidesenkende Behandlungunclassified

Das initiale Management des akuten Koronarsyndroms

Νικολάου

Arntz

Bellou

et al. 2015

Notfall Rettungsmed

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The Effect of Early, Intensive Statin Therapy on Acute Coronary Syndrome

Abstract: Early, intensive statin therapy reduces death and cardiovascular events after 4 months of treatment. The validity of this finding would be strengthened by an analysis of individual patient data.

Cited by 180 publications

References 46 publications

β‐Blocker Therapy Prior to Admission for Acute Coronary Syndrome in Patients Without Heart Failure or Left Ventricular Dysfunction Improves In‐Hospital and 12‐Month Outcome: Results From the GULF‐RACE 2 (Gulf Registry of Acute Coronary Events‐2)

β‐Blocker Therapy Prior to Admission for Acute Coronary Syndrome in Patients Without Heart Failure or Left Ventricular Dysfunction Improves In‐Hospital and 12‐Month Outcome: Results From the GULF‐RACE 2 (Gulf Registry of Acute Coronary Events‐2)

Effectiveness of a change in reperfusion strategy to primary percutaneous coronary intervention in a nonselected population

Das initiale Management des akuten Koronarsyndroms

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