Abstract 11810: Is the Presence of Statin Use Before Onset of Disease Associated With In-Hospital Mortality in Elderly Patients With Acute Myocardial Infarction?

Abstract

Introduction: The effect of statin on preventing cardiovascular events is clear, and aggressive lipid-lowering therapy with statins is strongly recommended for patients with coronary artery disease including of acute myocardial infarction (AMI). Hypothesis: The relationship between in-hospital mortality of AMI and statin use before onset of AMI in the elderly patients is unknown, we thus assessed. Methods: The subjects were 207 consecutive AMI patients aged 65 years or older who underwent successful percutaneous coronary intervention (PCI) at Kagoshima university hospital between January 2015 and March 2021. We investigated the association between in-hospital mortality after PCI and baseline characteristics including Global Registry of Acute Coronary Events (GRACE) risk score, which is widely used for estimating mortality in AMI patients. Results: Twenty-three patients (11%) died in-hospital. The mortality rate was significantly lower in patients who were taking statins at presentation compared to those who were not (3% vs. 16%, p=0.002). Univariate logistic regression analysis of risk factors for in-hospital mortality revealed that statin use before onset of AMI, level of serum albumin, level of high sensitivity C-reactive protein (hs-CRP) and GRACE risk score were associated with in-hospital mortality. Multivariate logistic analysis models adjusted for age, statin use, level of serum albumin, level of hs-CRP, and GRACE risk score showed that statin use [Odd's ratio (OR): 0.13, 95% confidence interval (CI): 0.02-0.81, p=0.029] and GRACE risk score (OR: 1.04, 95% CI: 1.02-1.06, p <0.001) were independently associated with in-hospital mortality. The optimal cut-off on the receiver-operating characteristic curve of GRACE risk score for predicting in-hospital mortality was 160. In addition, multivariate logistic analysis models using GRACE risk score ≥160 and non-use of statin before the onset of AMI showed greater risk of in-hospital mortality (HR 19.24; 95% CI 6.62-55.94; p <0.001) after PCI as compared to patients with GRACE risk score <160 and statins use. Conclusions: In elderly AMI patients undergoing PCI, statin use before the onset of AMI was an independent risk factor for in-hospital mortality, as was the GRACE risk score.