Abstract 470: Statin Treatment in Patients with Acute Myocardial Infarction According to Left Ventricular Systolic Function

Abstract

Aim: Statin decreases low density lipoprotein cholesterol level and prevents atherosclerosis. Although statin may be beneficial for patients with acute myocardial infarction (AMI) due to its direct anti-atherosclerotic effect, statin is not usually prescribed to all patients with AMI. This study was performed to identify different determinants of statin treatment and its prognostic impacts in patients with AMI according to their baseline LV systolic function. Methods: 12,988 patients with AMI were enrolled into nationwide registry database study. Patients were stratified into 2 groups according to their LV ejection fraction (LVEF): LVEF < 40% vs ≥ 40%, and determinant factors for statin treatment and MACE were identified in each group. Major adverse cardiovascular events (MACE) within 12 months of AMI including death, nonfatal MI and revascularization were assessed. Results: 1,962 patients (15.1%) with LVEF < 40% were older and had more un¬favorable cardiovascular risk factors than those with LVEF ≥ 40%. Statin treatment rate was significantly lower in group with LVEF < 40% than those with LVEF ≥ 40 % (70.5% vs 76.2%, p=0.001). Mean LDL-C level of patients with LVEF < 40% was lower than those with LVEF ≥ 40 %. MACE rate in patients with LVEF < 40% was higher than those with LVEF ≥ 40% (26.8% vs 11.4%, P < 0.001). Independent predictors for 12-month MACE in patients with LVEF ≥ 40% were history of previous myocardial infarction, high Killip stage, three vessel disease, and lower renal function, which are already known risk factors. Conclusions: The patients with LVEF < 40% were less treated with statin and showed lower LDL-C level and higher MACE rate than those with LVEF ≥ 40 %. Statin treatment may be considered in patients with AMI and LVEF < 40%.