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Statin Use in Patients with Acute Myocardial Infarction



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Am Fam Physician. 2001 Oct 1;64(7):1254-1256.

Long-term survival of persons with coronary artery disease (CAD) is associated with lipid-lowering therapy with a statin drug. The ability of statins to affect thrombosis, inflammation, platelet aggregation and endothelial function may be beneficial when administered concomitantly or very early following an acute myocardial infarction (AMI). Bybee and associates retrospectively reviewed data for patients admitted to a coronary care unit with AMI who had not undergone subsequent coronary bypass surgery.

A “statin group” included 66 patients who were taking a statin at the time of infarction or who received a statin during the first 24 hours following admission to the coronary care unit for AMI. The “non-statin group” included 198 patients (matched to the statin group for age [within five years], gender and previous history of CAD) who had not been taking a statin before admission and who did not receive a statin during the inpatient AMI treatment course. Ischemic complications were defined as post-AMI angina or recurrent infarction. Primary clinical end points included in-hospital death and repeat infarction. Secondary end points included rates of in-hospital ischemic complications and size of infarct. Patients in the statin group had a lower rate of the combined end points of death plus reinfarction, a lower in-hospital mortality rate, less ischemic complications and a significantly lower rate of creatinine release, possibly representing smaller infarcts.

The authors conclude that the results of their review suggest a beneficial effect from concomitant or very early (within 24 hours) statin therapy in patients with AMI.

Bybee KA, et al. Effect of concomitant or very early statin administration on in-hospital mortality and reinfarction in patients with acute myocardial infarction. Am J Cardiol. March 15, 2001;87:771–4.



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