Delayed Statin Treatment Reduces the Cardioprotective Effects on Congestive Heart Failure after Acute Myocardial Infarction

10.5083/ejcm.20424884.107 , Cite or Link Using DOI
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Tsuyoshi Honda MD, Kazuteru Fujimoto MD, Yuji Miyao MD, Hidenobu Koga MD, Masanobu Ishii MD


Background: It has been reported that early statin treatment can reduce the incidence of symptomatic heart failure and ischemic events after acute myocardial infarction (AMI).

Method: We studied 235 consecutive patients who underwent percutaneous coronary intervention within 24 hours after the onset of AMI and had a follow-up examination 5 to 10 months after AMI. They were divided into four groups based on type of statin treatment: early statin treatment (EST), delayed statin treatment (DST), no statin treatment (NST), and transient statin treatment (TST).

Results: There were no differences in coronary risk factors between the EST and DST groups. During follow-up (196 days), 18 patients (7.66%) were admitted for congestive heart failure (CHF). Multiple logistic regression analysis showed that the absence of EST (odds ratio, 5.83; p<0.05), Killip class ≥II (odds ratio, 5.27; p<0.01) and heart rate (odds ratio, 1.02; p<0.05) on admission were associated with the occurrence of CHF. Although the LV end-diastolic volume index significantly increased at follow-up compared with baseline in both the DST and NST groups ( p<0.05 for each), it didn’t in the EST group.

Conclusion: These findings indicated that EST might reduce the occurrence of CHF through attenuation of LV remodeling after AMI.