Statin therapy begun within 24 hours of acute myocardial infarction reduces in-hospital mortality by more than half

Initiation of a statin drug within 24 hours of an acute myocardial infarction reduces in-hospital mortality rates by over 50 percent, according to an article in the September 1 issue of the American Journal of Cardiology.

“We’ve known that long-term statin therapy is beneficial, but this study provides the strongest clinical evidence to date supporting the early cardioprotective effects of statins immediately following a heart attack,” said Dr. Gregg C. Fonarow, lead study author.

Researchers used data from over 170,000 patients in the National Registry of Myocardial Infarction 4, a US national database of patients admitted to a hospital for myocardial infarction.

Patients who received statin therapy before hospitalization and within 24 hours of an acute myocardial infarction had a 54-percent lower risk of in-hospital mortality compared with patients not on statin therapy.

Patients who had not received previous statin therapy but were started on medication within 24 hours of hospitalization had a 58-percent reduction in mortality compared with patients not on statin therapy.

Fonarow said, “We were surprised that early statin therapy showed such a striking effect immediately after a heart attack. We also found that statins provided additional protection from other heart attack complications as well.”

Early statin use was associated with a lower incidence of cardiac arrest, cardiac shock, cardiac rupture, and ventricular fibrillation during hospitalization.

The next step is to develop a clinical trial to corroborate these strong observational findings. Fonarow believes that early statin use within 24 hours of an acute myocardial infarction may become standard treatment. “As statins are already routinely started in myocardial infarction patients prior to hospital discharge, it would be relatively easy to administer this medication on arrival to the emergency department.”


 


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