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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...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2021
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8625617/ https://www.ncbi.nlm.nih.gov/pubmed/34833144 http://dx.doi.org/10.3390/life11111268 |
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author | Dadon, Ziv Moriel, Mady Iakobishvili, Zaza Asher, Elad Samuel, Tal Y. Gavish, Dov Glikson, Michael Gottlieb, Shmuel |
author_facet | Dadon, Ziv Moriel, Mady Iakobishvili, Zaza Asher, Elad Samuel, Tal Y. Gavish, Dov Glikson, Michael Gottlieb, Shmuel |
author_sort | Dadon, Ziv |
collection | PubMed |
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, p for trend < 0.001). Multivariate analysis revealed that HIST was independently associated with lower STEMI presentation (OR(adj) 0.70; 95% CI 0.57–0.86), while LIST (OR(adj) 0.92; 95% CI 0.77–1.10) and LDL-C < 70 mg/dL (OR(adj) 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. |
format | Online Article Text |
id | pubmed-8625617 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
spelling | pubmed-86256172021-11-27 Association of Contemporary Statin Pretreatment Intensity and LDL-C Levels on the Incidence of STEMI Presentation Dadon, Ziv Moriel, Mady Iakobishvili, Zaza Asher, Elad Samuel, Tal Y. Gavish, Dov Glikson, Michael Gottlieb, Shmuel Life (Basel) Article 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, p for trend < 0.001). Multivariate analysis revealed that HIST was independently associated with lower STEMI presentation (OR(adj) 0.70; 95% CI 0.57–0.86), while LIST (OR(adj) 0.92; 95% CI 0.77–1.10) and LDL-C < 70 mg/dL (OR(adj) 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. MDPI 2021-11-19 /pmc/articles/PMC8625617/ /pubmed/34833144 http://dx.doi.org/10.3390/life11111268 Text en © 2021 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/). |
spellingShingle | Article Dadon, Ziv Moriel, Mady Iakobishvili, Zaza Asher, Elad Samuel, Tal Y. Gavish, Dov Glikson, Michael Gottlieb, Shmuel Association of Contemporary Statin Pretreatment Intensity and LDL-C Levels on the Incidence of STEMI Presentation |
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 | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8625617/ https://www.ncbi.nlm.nih.gov/pubmed/34833144 http://dx.doi.org/10.3390/life11111268 |
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