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- Titel:
Prehospital statin therapy and one-year mortality in patients with stable coronary artery disease undergoing percutaneous coronary intervention.
- Dokumenttyp:
- Comparative Study; Journal Article
- Autor(en):
- Ndrepepa, Gjin; King, Lamin; Cassese, Salvatore; Fusaro, Massimiliano; Tada, Tomohisa; Schömig, Albert; Kastrati, Adnan
- Abstract:
- Statins have multiple effects in patients with coronary artery disease. No studies have investigated whether chronic statin pretreatment before percutaneous coronary intervention (PCI) has an impact on long-term mortality in patients with stable angina.The study included 8041 patients with stable angina. At the time of PCI, 5939 patients (73.8%) were receiving statins for >= 1 month before procedure and 2102 patients (26.2%) were not receiving statins. The primary outcome analysis was 1-year mortality.There were 192 deaths during the follow-up: 119 deaths among patients receiving statins and 73 deaths among patients not receiving statins (Kaplan-Meier estimates of 1-year mortality 2.06% and 3.59%; unadjusted hazards ratio [HR]=0.56, 95% confidence interval [CI] 0.42-0.75; P<0.001). Landmark analysis showed that almost all mortality benefit occurred in the first 30-days after PCI: 10 deaths among patients receiving statins and 22 deaths among patients not receiving statins (Kaplan-Meier estimates of 30-day death, 0.17% and 1.06%, respectively; HR=0.16, 95% CI 0.08-0.34, P<0.001). No significant difference in mortality according to statin pretreatment between 30 days and 1 year was observed (109 deaths among patients receiving statins vs 51 deaths among patients not receiving statins; Kaplan-Meier estimates 1.89% and 2.53%; HR=0.75, 95% CI 0.53-1.05, P=0.095). After adjustment in the Cox proportional hazards model, statin pretreatment was associated with a 35% reduction in the adjusted risk for 1-year mortality (adjusted HR=0.65, 95% CI 0.44-0.98, P=0.039).Pretreatment with statins before PCI was associated with a significant reduction of 1-year mortality in patients with stable angina.
- Zeitschriftentitel:
- Eur J Intern Med
- Jahr:
- 2013
- Band / Volume:
- 24
- Heft / Issue:
- 2
- Seitenangaben Beitrag:
- 145-50
- Sprache:
- eng
- Volltext / DOI:
- doi:10.1016/j.ejim.2012.10.008
- PubMed:
- http://view.ncbi.nlm.nih.gov/pubmed/23182629
- Print-ISSN:
- 0953-6205
- TUM Einrichtung:
- Klinik für Herz- und Kreislauferkrankungen im Erwachsenenalter (Prof. Schunkert)
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