Beneficial effects of statins after percutaneous coronary intervention

Abstract

Background Evidence about the efficacy of statin treatment among patients after percutaneous coronary intervention (PCI) is very limited. The rapid advancement in PCI technology and near universal use of adjunctive cardioprotective medications make it necessary to formally assess the effect of statin therapy on cardiac events after PCI. Design This was a multicenter prospective cohort study Methods Patients who received stent implantation and survived to hospital discharge from the National Heart, Lung, and Blood Institute Dynamic Registry from 2004 to 2006 formed the study cohort. Patients with cardiogenic shock, in-hospital adverse events [including myocardial infarction and coronary artery bypass graft surgery (CABG)], liver disease, renal disease, alcoholism, or drug abuse were excluded. The occurrences of death, CABG, and repeat PCI, and repeat revascularization were collected over 1-year follow-up. Results Of the 3227 patients evaluated, 2737 (85%) were prescribed a statin at discharge. By 1-year follow-up, incident events were 98 deaths, 44 CABG, 290 repeat PCI procedures, and 328 repeat revascularizations. After propensity score adjustment, postdischarge statin therapy was associated with lower risks of death [hazard ratio (HR)λ=λ0.58, 95% confidence interval (CI): 0.36–0.93, Pλ=λ0.02], CABG (HRλ=λ0.49, 95% CI: 0.24–1.00, Pλ=λ0.05), and repeat revascularization (HRλ=λ0.74, 95% CI: 0.56–1.00, Pλ=λ0.05). Conclusion These results support the routine use of statin therapy after PCI.

Association of Mild to Moderate Kidney Dysfunction with Coronary Artery Calcification in Patients with Suspected Coronary Artery Disease

“…Recent studies have shown that the presence of CKD is an independent predictor of subsequent CVD events and mortality in patients with a history of myocardial infarction [19,20,21], acute coronary syndromes [22] and revascularization procedures [23,24,25]. Despite the use of stent technology or optimal adjunctive medical therapy [26,27], the increased risk occurs in patients with moderate levels of CKD [28]. The mechanisms underlying the unfavorable outcome were not clearly elucidated.…”

Compliance with pharmacological treatment among patients after minimally invasive coronary bypass grafting

“…Also, we found a correlation between ingestion of antiplatelet agents and BB, and the need for readmission. Compliant individual less frequently experienced hospitalization compared to patients indifferent to pharmacotherapy, hence we assume that pharmacological interventions help improve patients' outcome and reduce costs for the healthcare system [21][22][23][24][25][26]. Although our study failed to demonstrate a statistically significant link between patients' clinical features and drug compliance, we managed to denote considerable prevalence of the issue of therapeutic non-adherence and its clinical implications.…”

Relevancy of High Dose Statins Application Before and After Myocardium Revascularization

“…Во всех, кроме одного, исследованиях статины назначались при стабильной стенокардии. По данным многоцентрового регистра, включившего 3 227 больных, назначение статинов в течение года после ЧКВ приводило к снижению риска смертельных исходов на 42% (ОР 0,58; 95% ДИ 0,36-0,93; р = 0,02), КШ -на 51% (0,49; 95% ДИ 0,24-1,00; р = 0,05), повторной реваскуляризации -на 26% (0,74; 95% ДИ 0,56-1,00; р = 0,05) [9].…”