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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