Assessment of Lipophilic vs. Hydrophilic Statin Therapy in Acute Myocardial Infarction

Izawa, Atsushi; Kashima, Yuichiro; Miura, Takashi; Ebisawa, Soichiro; Kitabayashi, Hiroshi; Yamamoto, Hiroaki; Sakurai, Shunpei; Kagoshima, Mitsuru; Tomita, Takeshi; Miyashita, Yusuke; Koyama, Jun; Ikeda, Uichi

doi:10.1253/circj.cj-14-0877

Cited by 37 publications

(26 citation statements)

References 44 publications

(23 reference statements)

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“…18,19) Briefly, patients were randomly allocated to receive either atorvastatin (264 patients) or pravastatin (261 patients) within 96 hours of a primary percutaneous coronary intervention. The inclusion criteria were age > 20 years, a serum lowdensity lipoprotein-cholesterol level (LDL) > 70 mg/dL, and percutaneous coronary intervention to treat AMI performed up to 96 hours prior to enrolment.…”

Section: Methodsmentioning

confidence: 99%

Comparison of Inflammatory Biomarkers in Outpatients With Prior Myocardial Infarction

et al. 2016

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SummaryInflammatory biomarkers have been proposed for use in the risk stratification of patients with acute myocardial infarction (AMI). We examined the value of inflammatory biomarkers over clinical features for predicting cardiovascular (CV) events in stable outpatients with MI. We enrolled 430 post-MI patients and measured their levels of high-sensitivity C reactive protein (hs-CRP), growth differentiation factor-15 (GDF-15), and the interleukin-1 receptor family member called ST2 (ST2), one month after AMI. Patients were prospectively followed for 3 years. In our study cohort (mean age, 66 ± 12 years; left ventricular ejection fraction, 55 ± 13%), CV events were observed in 39 patients (9.1%). KaplanMeier analysis revealed that patients with high levels of GDF-15 (≥ 1221.0 ng/L) showed poorer prognoses than those with low levels of GDF-15 (< 1221.0 ng/L) (20.4% versus 3.6%, P < 0.001); hs-CRP and ST2 did not show a similar correlation with prognoses. GDF-15 remained associated with CV events after adjusting for age, chronic kidney disease, and B-type natriuretic peptide (hazard ratio, 1.001; 95% confidence interval, 1.000 -1.001; P = 0.046). GDF-15 provided an incremental predictive value for CV events over clinical features (incremental value in global χ 2 = 43.81, P < 0.001). In outpatients with prior MI, GDF-15 was an independent indicator of CV events, unlike hs-CRP and ST2. GDF-15 provided an incremental prognostic value over clinical features. (Int Heart J 2016; 57: 11-17) Key words: Coronary artery disease, Growth differentiation factor-15, Prognosis I nflammatory biomarkers have been proposed for use in the risk stratification of patients with cardiovascular (CV) disease. 1-7) Patients with acute myocardial infarction (AMI) are at significant risk for recurrent CV events, such as death, recurrent MI, and heart failure. Novel biomarkers for patients with AMI are of interest because they may reveal pivotal disease mechanisms and potential therapeutic targets. 8)High-sensitivity C reactive protein (hs-CRP); growth differentiation factor-15 (GDF-15), a member of the transforming growth factor-β superfamily; and ST2, a member of the interleukin-1 receptor family, are strongly associated with CV events in AMI patients. [9][10][11][12][13][14][15][16] In clinically stable patients with acute decompensated heart failure, high levels of B-type natriuretic peptide (BNP) at the end of a hospitalization are strong, independent markers of CV events compared with levels during the acute phase.17) Secondary prevention of CV events is a crucial factor for the prognostic improvement in patients with AMI, and novel biomarkers provide important information about patient management if the biomarkers contribute to the risk stratification in these patients. However, the prognostic significance of inflammatory biomarkers for risk stratification in stable post-MI outpatients is poorly understood. Editorial p.1The aims of this study were to 1) compare the prognostic significance of inflammatory biomarkers for predicting C...

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Section: Methodsmentioning

confidence: 99%

Comparison of Inflammatory Biomarkers in Outpatients With Prior Myocardial Infarction

et al. 2016

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“…34 In an animal study, it has been demonstrated that lipophilic statins worsened myocardial stunning and reduced tissue ATP after coronary reperfusion; but the effects were not found with hydrophilic statins. 35 Several studies 13,36 have compared lipophilic and hydrophilic statins in clinical settings. One study showed that hydrophilic pravastatin could be superior to lipophilic statins for preventing new Q-wave appearance and reducing cardiovascular events in normocholesterolemic Japanese patients after AMI.…”

Section: Discussionmentioning

confidence: 99%

Association of Statin and Its Lipophilicity With Cardiovascular Events in Patients Receiving Chronic Dialysis

Wang

et al. 2019

Clin Pharma and Therapeutics

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Lipophilicity of statins has been linked to extrahepatic cell penetration and inhibition of isoprenoid synthesis and coenzyme Q10, which may affect myocardial contraction. Whether statins' lipophilicity affects the risk of cardiovascular disease development in patients under dialysis is unclear. This population‐based study included 114,929 patients undergoing chronic dialysis, retrieved from the Registry for Catastrophic Illness Patients from the National Health Insurance Research Database in Taiwan from 2000 to 2013. Statins were initiated after dialysis and classified into hydrophilic and lipophilic by the duration of use. In total, 17,015 statin users and match controls were identified by using propensity score matching in 1:1 ratio. New statin use was associated with higher cardiovascular disease risk (adjusted hazard ratio (aHR): 1.2, 95% confidence interval (CI), 1.13–1.28) but lower all‐cause mortality (aHR: 0.93, 95% CI, 0.89–0.96). Hydrophilic statins were significantly associated with lower risk of cardiovascular disease compared with lipophilic statins (aHR: 0.91, 95% CI, 0.85–0.97).

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“…[24,25] However, these differences between lipophilic and hydrophilic statins need to be clarified further. [26] …”

Section: Discussionmentioning

confidence: 99%

Statins and risk for new-onset diabetes mellitus

et al. 2016

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Assessment of Lipophilic vs. Hydrophilic Statin Therapy in Acute Myocardial Infarction

Cited by 37 publications

References 44 publications

Comparison of Inflammatory Biomarkers in Outpatients With Prior Myocardial Infarction

Comparison of Inflammatory Biomarkers in Outpatients With Prior Myocardial Infarction

Association of Statin and Its Lipophilicity With Cardiovascular Events in Patients Receiving Chronic Dialysis

Statins and risk for new-onset diabetes mellitus

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