Cargando…

Associations of pre-hospital statin treatment with in-hospital outcomes and severity of coronary artery disease in patients with first acute coronary syndrome-findings from the CCC-ACS project

BACKGROUND: The current burden of dyslipidemia, the pre-hospital application of statins and the association of pre-hospital statins with the severity of coronary artery disease (CAD) and in-hospital outcomes in Chinese patients with first acute coronary syndrome (ACS) are very significant and remain...

Descripción completa

Detalles Bibliográficos
Autores principales: Zhang, Lisha, Zhang, Yan, Chu, Chao, Deng, Fuxue, Zhou, Juan, Yuan, Zuyi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9889368/
https://www.ncbi.nlm.nih.gov/pubmed/36741846
http://dx.doi.org/10.3389/fcvm.2022.1030108
_version_ 1784880715143315456
author Zhang, Lisha
Zhang, Yan
Chu, Chao
Deng, Fuxue
Zhou, Juan
Yuan, Zuyi
author_facet Zhang, Lisha
Zhang, Yan
Chu, Chao
Deng, Fuxue
Zhou, Juan
Yuan, Zuyi
author_sort Zhang, Lisha
collection PubMed
description BACKGROUND: The current burden of dyslipidemia, the pre-hospital application of statins and the association of pre-hospital statins with the severity of coronary artery disease (CAD) and in-hospital outcomes in Chinese patients with first acute coronary syndrome (ACS) are very significant and remain unclear. METHODS: A total of 41,183 patients who underwent coronary angiography and were diagnosed with ACS for the first time from a nationwide registry study (CCC-ACS) were enrolled. The severity of CAD was assessed using the CAD prognostic index (CADPI). The patients were classified into statin and non-statin groups according to their pre-hospital statin treatment status. Clinical characteristics, CADPI and in-hospital outcomes were compared, and a logistic regression analysis was performed to determine whether pre-hospital statin therapy is associated with in-hospital outcomes and CADPI. A sensitivity analysis was used to further explore the issues above. RESULTS: The non-statin group had more in-hospital all-cause deaths (1.2 vs. 0.8%, P = 0.010). However, no association exists between statin pretreatment and in-hospital major adverse cardiovascular events (MACEs) or all-cause deaths in the entire population and subgroups (all P > 0.05). Surprisingly, statin pretreatment was associated with an 8.9% higher risk of severely obstructive CAD (CADPI ≥ 37) (OR, 1.089; 95% CI, 1.010–1.175, P = 0.028), and similar results were observed in subgroups of females, those aged 50 to 75 years, and patients with hypertension. CONCLUSION: Statin pretreatment was not related to MACEs or all-cause death during hospital stay, but it was associated with a higher risk of increased angiographic severity in patients with first ACS.
format Online
Article
Text
id pubmed-9889368
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-98893682023-02-02 Associations of pre-hospital statin treatment with in-hospital outcomes and severity of coronary artery disease in patients with first acute coronary syndrome-findings from the CCC-ACS project Zhang, Lisha Zhang, Yan Chu, Chao Deng, Fuxue Zhou, Juan Yuan, Zuyi Front Cardiovasc Med Cardiovascular Medicine BACKGROUND: The current burden of dyslipidemia, the pre-hospital application of statins and the association of pre-hospital statins with the severity of coronary artery disease (CAD) and in-hospital outcomes in Chinese patients with first acute coronary syndrome (ACS) are very significant and remain unclear. METHODS: A total of 41,183 patients who underwent coronary angiography and were diagnosed with ACS for the first time from a nationwide registry study (CCC-ACS) were enrolled. The severity of CAD was assessed using the CAD prognostic index (CADPI). The patients were classified into statin and non-statin groups according to their pre-hospital statin treatment status. Clinical characteristics, CADPI and in-hospital outcomes were compared, and a logistic regression analysis was performed to determine whether pre-hospital statin therapy is associated with in-hospital outcomes and CADPI. A sensitivity analysis was used to further explore the issues above. RESULTS: The non-statin group had more in-hospital all-cause deaths (1.2 vs. 0.8%, P = 0.010). However, no association exists between statin pretreatment and in-hospital major adverse cardiovascular events (MACEs) or all-cause deaths in the entire population and subgroups (all P > 0.05). Surprisingly, statin pretreatment was associated with an 8.9% higher risk of severely obstructive CAD (CADPI ≥ 37) (OR, 1.089; 95% CI, 1.010–1.175, P = 0.028), and similar results were observed in subgroups of females, those aged 50 to 75 years, and patients with hypertension. CONCLUSION: Statin pretreatment was not related to MACEs or all-cause death during hospital stay, but it was associated with a higher risk of increased angiographic severity in patients with first ACS. Frontiers Media S.A. 2023-01-18 /pmc/articles/PMC9889368/ /pubmed/36741846 http://dx.doi.org/10.3389/fcvm.2022.1030108 Text en Copyright © 2023 Zhang, Zhang, Chu, Deng, Zhou and Yuan. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Cardiovascular Medicine
Zhang, Lisha
Zhang, Yan
Chu, Chao
Deng, Fuxue
Zhou, Juan
Yuan, Zuyi
Associations of pre-hospital statin treatment with in-hospital outcomes and severity of coronary artery disease in patients with first acute coronary syndrome-findings from the CCC-ACS project
title Associations of pre-hospital statin treatment with in-hospital outcomes and severity of coronary artery disease in patients with first acute coronary syndrome-findings from the CCC-ACS project
title_full Associations of pre-hospital statin treatment with in-hospital outcomes and severity of coronary artery disease in patients with first acute coronary syndrome-findings from the CCC-ACS project
title_fullStr Associations of pre-hospital statin treatment with in-hospital outcomes and severity of coronary artery disease in patients with first acute coronary syndrome-findings from the CCC-ACS project
title_full_unstemmed Associations of pre-hospital statin treatment with in-hospital outcomes and severity of coronary artery disease in patients with first acute coronary syndrome-findings from the CCC-ACS project
title_short Associations of pre-hospital statin treatment with in-hospital outcomes and severity of coronary artery disease in patients with first acute coronary syndrome-findings from the CCC-ACS project
title_sort associations of pre-hospital statin treatment with in-hospital outcomes and severity of coronary artery disease in patients with first acute coronary syndrome-findings from the ccc-acs project
topic Cardiovascular Medicine
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9889368/
https://www.ncbi.nlm.nih.gov/pubmed/36741846
http://dx.doi.org/10.3389/fcvm.2022.1030108
work_keys_str_mv AT zhanglisha associationsofprehospitalstatintreatmentwithinhospitaloutcomesandseverityofcoronaryarterydiseaseinpatientswithfirstacutecoronarysyndromefindingsfromthecccacsproject
AT zhangyan associationsofprehospitalstatintreatmentwithinhospitaloutcomesandseverityofcoronaryarterydiseaseinpatientswithfirstacutecoronarysyndromefindingsfromthecccacsproject
AT chuchao associationsofprehospitalstatintreatmentwithinhospitaloutcomesandseverityofcoronaryarterydiseaseinpatientswithfirstacutecoronarysyndromefindingsfromthecccacsproject
AT dengfuxue associationsofprehospitalstatintreatmentwithinhospitaloutcomesandseverityofcoronaryarterydiseaseinpatientswithfirstacutecoronarysyndromefindingsfromthecccacsproject
AT zhoujuan associationsofprehospitalstatintreatmentwithinhospitaloutcomesandseverityofcoronaryarterydiseaseinpatientswithfirstacutecoronarysyndromefindingsfromthecccacsproject
AT yuanzuyi associationsofprehospitalstatintreatmentwithinhospitaloutcomesandseverityofcoronaryarterydiseaseinpatientswithfirstacutecoronarysyndromefindingsfromthecccacsproject