TY - JOUR
T1 - Hydrophilic Versus Lipophilic Statin Treatments in Patients With Renal Impairment After Acute Myocardial Infarction
AU - Kang, Min Hye
AU - Kim, Weon
AU - Kim, Jin Sug
AU - Jeong, Kyung Hwan
AU - Jeong, Myung Ho
AU - Hwang, Jin Yong
AU - Hur, Seung Ho
AU - Hwang, Hyeon Seok
N1 - Funding Information:
This research was supported by funding from the Research of Korea Centers for Disease Control and Prevention (2016-ER6304-02).
Funding Information:
This research was supported by the Research of Korea Centers for Disease Control and Prevention (2016-ER6304-02).
Publisher Copyright:
© 2022 The Authors.
PY - 2022/6/7
Y1 - 2022/6/7
N2 - BACKGROUND: Hydrophilic and lipophilic statins have similar efficacies in treating coronary artery disease. However, specific factors relevant to renal impairment and different arterial pathogeneses could modify the clinical effects of statin lipophilicity, and create differences in protective effects between statin types in patients with renal impairment. METHODS AND RESULTS: A total of 2062 patients with acute myocardial infarction with an estimated glomerular filtration rate <60 mL/min per 1.73 m2 were enrolled from the Korea Acute Myocardial Infarction Registry between November 2011 and December 2015. The primary end point was a composite of 2-year major adverse cardiac and cerebrovascular events (MACEs) after acute myocardial infarction occurrence. MACEs were defined as all-cause death, recurrent myocardial infarction, revascularization, and stroke. Propensity-score matching and Cox proportional hazards regression were performed. A total of 529 patients treated with hydrophilic statins were matched to 529 patients treated with lipophilic statins. There was no difference in the statin equivalent dose between the 2 statin groups. The cumulative event rate of MACEs, all-cause mortality, and recurrent myocardial infarction were significantly lower in patients treated with hydrophilic statins in the propensity-score matched population (all P<0.05). In the multivariable Cox regression analysis, patients treated with hydrophilic statins had a lower risk for composite MACEs (hazard ratio [HR], 0.70 [95% CI, 0.55– 0.90]), all-cause mortality (HR, 0.67 [95% CI, 0.49– 0.93]), and recurrent myocardial infarction (HR, 0.40 [95% CI, 0.21– 0.73]), but not for revascularization and ischemic stroke. CONCLUSIONS: Hydrophilic statin treatment was associated with lower risk of MACEs and all-cause mortality than lipophilic statin in a propensity-score matched observational cohort of patients with renal impairment following acute myocardial infarction.
AB - BACKGROUND: Hydrophilic and lipophilic statins have similar efficacies in treating coronary artery disease. However, specific factors relevant to renal impairment and different arterial pathogeneses could modify the clinical effects of statin lipophilicity, and create differences in protective effects between statin types in patients with renal impairment. METHODS AND RESULTS: A total of 2062 patients with acute myocardial infarction with an estimated glomerular filtration rate <60 mL/min per 1.73 m2 were enrolled from the Korea Acute Myocardial Infarction Registry between November 2011 and December 2015. The primary end point was a composite of 2-year major adverse cardiac and cerebrovascular events (MACEs) after acute myocardial infarction occurrence. MACEs were defined as all-cause death, recurrent myocardial infarction, revascularization, and stroke. Propensity-score matching and Cox proportional hazards regression were performed. A total of 529 patients treated with hydrophilic statins were matched to 529 patients treated with lipophilic statins. There was no difference in the statin equivalent dose between the 2 statin groups. The cumulative event rate of MACEs, all-cause mortality, and recurrent myocardial infarction were significantly lower in patients treated with hydrophilic statins in the propensity-score matched population (all P<0.05). In the multivariable Cox regression analysis, patients treated with hydrophilic statins had a lower risk for composite MACEs (hazard ratio [HR], 0.70 [95% CI, 0.55– 0.90]), all-cause mortality (HR, 0.67 [95% CI, 0.49– 0.93]), and recurrent myocardial infarction (HR, 0.40 [95% CI, 0.21– 0.73]), but not for revascularization and ischemic stroke. CONCLUSIONS: Hydrophilic statin treatment was associated with lower risk of MACEs and all-cause mortality than lipophilic statin in a propensity-score matched observational cohort of patients with renal impairment following acute myocardial infarction.
KW - acute myocardial infarction
KW - hydrophilic statin
KW - major adverse cardiac and cerebrovascular events
KW - renal impairment
KW - statin lipophilicity
UR - http://www.scopus.com/inward/record.url?scp=85132278160&partnerID=8YFLogxK
U2 - 10.1161/JAHA.121.024649
DO - 10.1161/JAHA.121.024649
M3 - Article
C2 - 35656978
AN - SCOPUS:85132278160
VL - 11
JO - Journal of the American Heart Association
JF - Journal of the American Heart Association
SN - 2047-9980
IS - 11
M1 - e024649
ER -