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High versus low dose statin therapy in Indian patients with acute ST-segment elevation myocardial infarction undergoing thrombolysis
OBJECTIVES: This study sought to compare high dose versus low dose statin therapy in Indian patients with ST-segment elevation myocardial infarction (STEMI) undergoing thrombolysis. BACKGROUND: Randomized trials have demonstrated that statin treatment reduced major adverse cardiac events (MACEs) in...
Autores principales: | , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elsevier
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5560891/ https://www.ncbi.nlm.nih.gov/pubmed/28822510 http://dx.doi.org/10.1016/j.ihj.2017.05.026 |
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author | Priti, K. Agrawal, Anand Ranwa, Bhanwar L. |
author_facet | Priti, K. Agrawal, Anand Ranwa, Bhanwar L. |
author_sort | Priti, K. |
collection | PubMed |
description | OBJECTIVES: This study sought to compare high dose versus low dose statin therapy in Indian patients with ST-segment elevation myocardial infarction (STEMI) undergoing thrombolysis. BACKGROUND: Randomized trials have demonstrated that statin treatment reduced major adverse cardiac events (MACEs) in patients with stable angina pectoris and acute coronary syndrome. However, randomized studies of statin therapy in Indian patients with STEMI are scarce. METHODS: Of 1859 patients with acute STEMI, 1027 eligible patients were randomized to 80-mg (n = 512) or 10-mg (n = 515) atorvastatin. Primary end point was 30-day incidence of MACE (death from any cause, myocardial infarction, NSTE-ACS requiring readmission, ischemia driven revascularization, and stroke). Secondary end points included individual components of primary end point and ST-segment resolution at 90 min after thrombolysis. RESULTS: Two groups did not differ in primary endpoints of MACEs (8.79% in high dose vs 9.32% in low dose atorvastatin group, OR = 0.938, 95% CI = 0.612–1.436, P = 0.764). With 80 mg atorvastatin, there was insignificant reduction in rate of reinfarction, revascularization and death. Stroke and readmission for NSTE-ACS increased in 80 mg atrovastatin group, but was not statistically significant. ST-segment resolution was significantly higher in 80-mg atorvastatin arm (45.90% vs. 37.67%; p = 0.008). Myalgia was more in 80 mg statin group (18.06% vs 7.57%, p = 0.0001). CONCLUSIONS: High-dose atorvastatin did not show significant difference of MACEs in STEMI patients undergoing thrombolysis but showed significant improvement in immediate coronary flow depicted by ST-segment resolution. This benefit of high dose statin is to be weighed against greater myalgia, drug discontinuation and cost in Indian patients. |
format | Online Article Text |
id | pubmed-5560891 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Elsevier |
record_format | MEDLINE/PubMed |
spelling | pubmed-55608912018-07-01 High versus low dose statin therapy in Indian patients with acute ST-segment elevation myocardial infarction undergoing thrombolysis Priti, K. Agrawal, Anand Ranwa, Bhanwar L. Indian Heart J Original Article OBJECTIVES: This study sought to compare high dose versus low dose statin therapy in Indian patients with ST-segment elevation myocardial infarction (STEMI) undergoing thrombolysis. BACKGROUND: Randomized trials have demonstrated that statin treatment reduced major adverse cardiac events (MACEs) in patients with stable angina pectoris and acute coronary syndrome. However, randomized studies of statin therapy in Indian patients with STEMI are scarce. METHODS: Of 1859 patients with acute STEMI, 1027 eligible patients were randomized to 80-mg (n = 512) or 10-mg (n = 515) atorvastatin. Primary end point was 30-day incidence of MACE (death from any cause, myocardial infarction, NSTE-ACS requiring readmission, ischemia driven revascularization, and stroke). Secondary end points included individual components of primary end point and ST-segment resolution at 90 min after thrombolysis. RESULTS: Two groups did not differ in primary endpoints of MACEs (8.79% in high dose vs 9.32% in low dose atorvastatin group, OR = 0.938, 95% CI = 0.612–1.436, P = 0.764). With 80 mg atorvastatin, there was insignificant reduction in rate of reinfarction, revascularization and death. Stroke and readmission for NSTE-ACS increased in 80 mg atrovastatin group, but was not statistically significant. ST-segment resolution was significantly higher in 80-mg atorvastatin arm (45.90% vs. 37.67%; p = 0.008). Myalgia was more in 80 mg statin group (18.06% vs 7.57%, p = 0.0001). CONCLUSIONS: High-dose atorvastatin did not show significant difference of MACEs in STEMI patients undergoing thrombolysis but showed significant improvement in immediate coronary flow depicted by ST-segment resolution. This benefit of high dose statin is to be weighed against greater myalgia, drug discontinuation and cost in Indian patients. Elsevier 2017 2017-05-30 /pmc/articles/PMC5560891/ /pubmed/28822510 http://dx.doi.org/10.1016/j.ihj.2017.05.026 Text en © 2017 Published by Elsevier B.V., a division of Reed Elsevier India, Pvt. Ltd on behalf of Cardiological Society of India. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/). |
spellingShingle | Original Article Priti, K. Agrawal, Anand Ranwa, Bhanwar L. High versus low dose statin therapy in Indian patients with acute ST-segment elevation myocardial infarction undergoing thrombolysis |
title | High versus low dose statin therapy in Indian patients with acute ST-segment elevation myocardial infarction undergoing thrombolysis |
title_full | High versus low dose statin therapy in Indian patients with acute ST-segment elevation myocardial infarction undergoing thrombolysis |
title_fullStr | High versus low dose statin therapy in Indian patients with acute ST-segment elevation myocardial infarction undergoing thrombolysis |
title_full_unstemmed | High versus low dose statin therapy in Indian patients with acute ST-segment elevation myocardial infarction undergoing thrombolysis |
title_short | High versus low dose statin therapy in Indian patients with acute ST-segment elevation myocardial infarction undergoing thrombolysis |
title_sort | high versus low dose statin therapy in indian patients with acute st-segment elevation myocardial infarction undergoing thrombolysis |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5560891/ https://www.ncbi.nlm.nih.gov/pubmed/28822510 http://dx.doi.org/10.1016/j.ihj.2017.05.026 |
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