The impact of high-intensity statin on 3-year clinical outcomes in elderly acute myocardial infarction patients underwent percutaneous coronary intervention with drug-eluting stents

Abstract Background There is limited data on role of high-intensity statin for secondary prevention in elderly acute myocardial infarction (AMI) patients above 75 years old. Therefore, this study aimed to show the impact of high-intensity statin on 3-year clinical outcomes in elderly AMI patients (>75 years) underwent percutaneous coronary intervention (PCI) with drug-eluting stents (DES). Methods Among the 13,104 patients included in the Korea AMI registry (KAMIR)-National Institutes of Health (NIH), the elderly patients (>75 years, n=2063) were divided into three groups according to statin treatment at discharge; the high-intensity statin group (n=521), the low/moderate-intensity statin group (n=1419), and the no statin group (n=123). The primary endpoint was 3-year composite of cardiac death and recurrent myocardial infarction (MI). Results During the 3-year clinical follow-up, the cumulative incidence of primary endpoint in the high-intensity statin group was similar to that of the low/moderate-intensity statin group (11.5% versus 12.5%; adjusted hazard ratio [aHR]: 1.053; 95% confidence interval [CI]: 0.780-1.423; P=0.739) and was significantly lower than that of the no statin group after adjustment (11.5% versus 22.0%; aHR: 2.433; 95% CI: 1.377-4.298; P=0.002). The incidences of major adverse cardiac events (MACE), target lesion failure (TLF), target vessel failure (TVF), procedure free cardiac events (PFCE), total death, cardiac death, and re-hospitalization due to heart failure (HF) in the high-intensity statin group were significantly lower than those of the no statin group after adjustment. However, the incidences of primary endpoint and other clinical events in the high-intensity statin group were similar to those of the low/moderate-intensity statin group. Conclusions In elderly AMI patients (>75 years) underwent PCI with DES, high-intensity statin was associated with significantly reduced 3-year major clinical outcomes than no statin therapy group. This clinical benefit was similar to low/moderate-intensity statin therapy.