Abstract
BackgroundHigh-intensity statin therapy is typically used in patients with acute myocardial infarction (AMI) for secondary prevention. However, there have been consistent concerns regarding its association with diabetes mellitus. We investigated the effect of high-intensity atorvastatin and rosuvastatin on new-onset diabetes mellitus (NODM) and cardiovascular outcomes over a 3-year follow-up period.MethodsData from the Korea Acute Myocardial Infarction Registry were collected from November 2011 to October 2015, and 13,104 patients with AMI were enrolled from major cardiovascular centers. Among them, 2221 patients without diabetes who had been administered with high-intensity atorvastatin (40–80 mg) and rosuvastatin (20 mg) were investigated. The atorvastatin and rosuvastatin groups were evaluated for the incidence of NODM and major adverse cardiac events (MACE) including death, myocardial infarction, and revascularization cases in the following 3 years.ResultsBaseline characteristics were comparable between the two groups. Event-free survival rate of NODM was not significantly different between the atorvastatin and rosuvastatin groups (92.5% vs. 90.8%, respectively; Log-rank P-value = 0.550). The event-free survival rate of MACE was also not significantly different between atorvastatin and rosuvastatin groups (89.0% vs. 89.6%, respectively; Log rank P-value = 0.662). Multivariate Cox analysis revealed that statin type was not a prognostic factor in the development of NODM and MACE.ConclusionsAdministering high-intensity atorvastatin and rosuvastatin in patients with AMI produced comparable effects on NODM and clinical outcomes, suggesting their clinical equivalence in secondary prevention.
Highlights
High-intensity statin therapy is typically used in patients with acute myocardial infarction (AMI) for secondary prevention
We investigated the effect of highintensity atorvastatin and rosuvastatin on cardiovascular outcomes and new-onset diabetes mellitus (NODM) in patients with AMI over a 3-year follow-up period
Data collection and study population The Korea Acute Myocardial Infarction Registry (KAMI R), a Korean prospective, multicenter, nationwide database supported by the Korean Society of Cardiology, reflects real-world clinical practices of AMI patients in Asian
Summary
High-intensity statin therapy is typically used in patients with acute myocardial infarction (AMI) for secondary prevention. We investigated the effect of high-intensity atorvastatin and rosuvastatin on new-onset diabetes mellitus (NODM) and cardiovascular outcomes over a 3-year follow-up period. Statins typically prevent cardiovascular events by lowering total and low-density lipoprotein (LDL) cholesterol levels in the serum Considering their rapid and sustained clinical advantages, the current guideline recommends administration of high-intensity statins in patients with acute myocardial infarction (AMI) for secondary prevention. Meta-analysis of five large-scale trials comparing intensive and moderate doses of statins have demonstrated that the risk of NODM further increases in intensive therapy groups [4]. It is unclear if the diabetogenic effect of statins is a class effect. We investigated the effect of highintensity atorvastatin and rosuvastatin on cardiovascular outcomes and NODM in patients with AMI over a 3-year follow-up period
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