急性冠状动脉综合征PCI前慢性他汀类药物使用和住院结果：印度ACCNCDR登记

IF 4.3 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

American journal of preventive cardiology Pub Date : 2025-04-19 DOI:10.1016/j.ajpc.2025.100999

Rajeev Gupta , Prashant Dwivedi , Krishna K Sharma , Sanjeev K Sharma , Jitender S Makkar , Atul Kasliwal , Vishnu Natani , Raghubir S Khedar , Samin K Sharma , Soneil Guptha

{"title":"急性冠状动脉综合征PCI前慢性他汀类药物使用和住院结果：印度ACCNCDR登记","authors":"Rajeev Gupta , Prashant Dwivedi , Krishna K Sharma , Sanjeev K Sharma , Jitender S Makkar , Atul Kasliwal , Vishnu Natani , Raghubir S Khedar , Samin K Sharma , Soneil Guptha","doi":"10.1016/j.ajpc.2025.100999","DOIUrl":null,"url":null,"abstract":"<div><h3>Objective</h3><div>To compare in-hospital major cardiovascular adverse outcomes among chronic statin-user and statin-naïve acute coronary syndrome(ACS) patients following percutaneous coronary intervention(PCI).</div></div><div><h3>Methods</h3><div>Successive patients with ACS who underwent PCI from Sep’17 to Dec’23 were enrolled in a prospective registry. Details of risk factors, presentation, angiography, interventions, and in-hospital outcomes were recorded. Chronic statin use was defined as > 1-month intake before presentation. Primary outcomes were in-hospital all-cause and cardiovascular deaths. Univariate and multivariate odds ratios(OR) and 95 % confidence intervals(CI) were calculated.</div></div><div><h3>Results</h3><div>8296 patients were enrolled, and ACS was in 7892(STEMI-ST elevation myocardial infarction 3222, non-STEMI/unstable angina 4670). Prior chronic statin use was in 2949(37.4 %), and 4943(62.6 %) were statin naïve. Statin-user vs. statin-naïve patients were older(62±10 vs. 60±11y), with more hypertension(61 vs. 48 %), diabetes(36 vs. 32 %), prior PCI(20 vs 8 %), CABG(5 vs 2 %), beta-blockers(61.7 vs 8.3 %), anti-platelets(92.8 vs 5.3 %), and lower mean total-, LDL-, and non-HDL-cholesterol(<em>p</em> < 0.001); chronic statin users had less STEMI(30 % vs 47 %) and better LVEF(46.5 ± 10 vs 44.5 ± 10 %) at presentation and median hospitalization was shorter(66.3 vs 68.6 h)(<em>p</em> < 0.001). In statin-user vs. statin-naïve groups, the incidence of all-cause deaths: 33(1.12 %) vs 85(1.72 %) (OR 0.65, CI 0.43–0.97) and CV deaths: in 29(0.98 %) vs 73(1.47 %) (OR 0.67, CI 0.43–1.02) were lower. The ORs attenuated following multivariate adjustments for risk factors, previous treatments, clinical features, angiographic findings and interventions.</div></div><div><h3>Conclusions</h3><div>Acute coronary syndrome patients taking pre-admission statins and other cardioprotective medicines have lower in-hospital all-cause deaths. This is associated with less STEMI, better LVEF, and shorter hospitalization in prior statin users.</div></div>","PeriodicalId":72173,"journal":{"name":"American journal of preventive cardiology","volume":"22 ","pages":"Article 100999"},"PeriodicalIF":4.3000,"publicationDate":"2025-04-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Chronic statin-use before PCI in acute coronary syndromes and in-hospital outcomes: ACCNCDR registry in India\",\"authors\":\"Rajeev Gupta , Prashant Dwivedi , Krishna K Sharma , Sanjeev K Sharma , Jitender S Makkar , Atul Kasliwal , Vishnu Natani , Raghubir S Khedar , Samin K Sharma , Soneil Guptha\",\"doi\":\"10.1016/j.ajpc.2025.100999\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Objective</h3><div>To compare in-hospital major cardiovascular adverse outcomes among chronic statin-user and statin-naïve acute coronary syndrome(ACS) patients following percutaneous coronary intervention(PCI).</div></div><div><h3>Methods</h3><div>Successive patients with ACS who underwent PCI from Sep’17 to Dec’23 were enrolled in a prospective registry. Details of risk factors, presentation, angiography, interventions, and in-hospital outcomes were recorded. Chronic statin use was defined as > 1-month intake before presentation. Primary outcomes were in-hospital all-cause and cardiovascular deaths. Univariate and multivariate odds ratios(OR) and 95 % confidence intervals(CI) were calculated.</div></div><div><h3>Results</h3><div>8296 patients were enrolled, and ACS was in 7892(STEMI-ST elevation myocardial infarction 3222, non-STEMI/unstable angina 4670). Prior chronic statin use was in 2949(37.4 %), and 4943(62.6 %) were statin naïve. Statin-user vs. statin-naïve patients were older(62±10 vs. 60±11y), with more hypertension(61 vs. 48 %), diabetes(36 vs. 32 %), prior PCI(20 vs 8 %), CABG(5 vs 2 %), beta-blockers(61.7 vs 8.3 %), anti-platelets(92.8 vs 5.3 %), and lower mean total-, LDL-, and non-HDL-cholesterol(<em>p</em> < 0.001); chronic statin users had less STEMI(30 % vs 47 %) and better LVEF(46.5 ± 10 vs 44.5 ± 10 %) at presentation and median hospitalization was shorter(66.3 vs 68.6 h)(<em>p</em> < 0.001). In statin-user vs. statin-naïve groups, the incidence of all-cause deaths: 33(1.12 %) vs 85(1.72 %) (OR 0.65, CI 0.43–0.97) and CV deaths: in 29(0.98 %) vs 73(1.47 %) (OR 0.67, CI 0.43–1.02) were lower. The ORs attenuated following multivariate adjustments for risk factors, previous treatments, clinical features, angiographic findings and interventions.</div></div><div><h3>Conclusions</h3><div>Acute coronary syndrome patients taking pre-admission statins and other cardioprotective medicines have lower in-hospital all-cause deaths. This is associated with less STEMI, better LVEF, and shorter hospitalization in prior statin users.</div></div>\",\"PeriodicalId\":72173,\"journal\":{\"name\":\"American journal of preventive cardiology\",\"volume\":\"22 \",\"pages\":\"Article 100999\"},\"PeriodicalIF\":4.3000,\"publicationDate\":\"2025-04-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"American journal of preventive cardiology\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S2666667725000741\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"American journal of preventive cardiology","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666667725000741","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}

引用次数: 0

摘要

目的比较经皮冠状动脉介入治疗（PCI）后长期使用他汀类药物和未使用他汀类药物的急性冠状动脉综合征（ACS）患者的院内主要心血管不良预后。方法将 17 年 9 月至 23 年 12 月期间接受 PCI 治疗的急性冠状动脉综合征（ACS）患者纳入前瞻性登记。详细记录了危险因素、发病情况、血管造影、介入治疗和院内预后。他汀类药物的长期使用定义为发病前1个月内服用他汀类药物。主要结果是院内全因死亡和心血管死亡。计算了单变量和多变量几率比（OR）及95%置信区间（CI）。结果 8296名患者入选，其中ACS患者7892名（STEMI-ST段抬高型心肌梗死3222名，非STEMI/不稳定型心绞痛4670名）。2949人（37.4%）曾长期使用他汀类药物，4943人（62.6%）未使用过他汀类药物。使用他汀与未使用他汀的患者年龄更大（62±10 岁 vs. 60±11岁），高血压（61% vs. 48%）、糖尿病（36% vs. 32%）、PCI（20% vs. 8%）、CABG（5% vs. 2%）、β-受体阻滞剂（61.7% vs. 8.3%）、抗血小板药物（92.8% vs. 5.他汀类药物长期使用者的 STEMI（30% vs 47%）较少，发病时 LVEF（46.5 ± 10 vs 44.5 ± 10%）较好，中位住院时间较短（66.3 vs 68.6 h）（p < 0.001）。使用他汀类药物组与未使用他汀类药物组相比，全因死亡发生率较低：33（1.12%） vs 85（1.72%）（OR 0.65，CI 0.43-0.97），冠心病死亡发生率较低：29（0.98%） vs 73（1.47%）（OR 0.67，CI 0.43-1.02）。在对风险因素、既往治疗、临床特征、血管造影结果和干预措施进行多变量调整后，OR 值有所降低。结论入院前服用他汀类药物和其他心脏保护药物的急性冠状动脉综合征患者的院内全因死亡率较低，这与他汀类药物使用者STEMI较少、LVEF较好和住院时间较短有关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Chronic statin-use before PCI in acute coronary syndromes and in-hospital outcomes: ACCNCDR registry in India

查看原文本刊更多论文

Chronic statin-use before PCI in acute coronary syndromes and in-hospital outcomes: ACCNCDR registry in India

Objective

To compare in-hospital major cardiovascular adverse outcomes among chronic statin-user and statin-naïve acute coronary syndrome(ACS) patients following percutaneous coronary intervention(PCI).

Methods

Successive patients with ACS who underwent PCI from Sep’17 to Dec’23 were enrolled in a prospective registry. Details of risk factors, presentation, angiography, interventions, and in-hospital outcomes were recorded. Chronic statin use was defined as > 1-month intake before presentation. Primary outcomes were in-hospital all-cause and cardiovascular deaths. Univariate and multivariate odds ratios(OR) and 95 % confidence intervals(CI) were calculated.

Results

8296 patients were enrolled, and ACS was in 7892(STEMI-ST elevation myocardial infarction 3222, non-STEMI/unstable angina 4670). Prior chronic statin use was in 2949(37.4 %), and 4943(62.6 %) were statin naïve. Statin-user vs. statin-naïve patients were older(62±10 vs. 60±11y), with more hypertension(61 vs. 48 %), diabetes(36 vs. 32 %), prior PCI(20 vs 8 %), CABG(5 vs 2 %), beta-blockers(61.7 vs 8.3 %), anti-platelets(92.8 vs 5.3 %), and lower mean total-, LDL-, and non-HDL-cholesterol(p < 0.001); chronic statin users had less STEMI(30 % vs 47 %) and better LVEF(46.5 ± 10 vs 44.5 ± 10 %) at presentation and median hospitalization was shorter(66.3 vs 68.6 h)(p < 0.001). In statin-user vs. statin-naïve groups, the incidence of all-cause deaths: 33(1.12 %) vs 85(1.72 %) (OR 0.65, CI 0.43–0.97) and CV deaths: in 29(0.98 %) vs 73(1.47 %) (OR 0.67, CI 0.43–1.02) were lower. The ORs attenuated following multivariate adjustments for risk factors, previous treatments, clinical features, angiographic findings and interventions.

Conclusions

Acute coronary syndrome patients taking pre-admission statins and other cardioprotective medicines have lower in-hospital all-cause deaths. This is associated with less STEMI, better LVEF, and shorter hospitalization in prior statin users.

求助全文

通过发布文献求助，成功后即可免费获取论文全文。去求助

来源期刊

American journal of preventive cardiology Cardiology and Cardiovascular Medicine

CiteScore

6.60

自引率

0.00%

发文量

审稿时长

76 days