Association of Contemporary Statin Pretreatment Intensity and LDL-C Levels on the Incidence of STEMI Presentation

Constituting hypolipidemic and pleiotropic effects, statins stabilize coronary artery plaque and may prevent STEMI events. This study investigated the association between contemporary statin pretreatment intensity, low-density lipoprotein cholesterol (LDL-C) levels, and the type of acute coronary sy...

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Autores principales:	Ziv Dadon, Mady Moriel, Zaza Iakobishvili, Elad Asher, Tal Y. Samuel, Dov Gavish, Michael Glikson, Shmuel Gottlieb
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	acute coronary syndrome low-density lipoprotein cholesterol myocardial infarction primary prevention secondary prevention statin Science Q
Acceso en línea:	https://doaj.org/article/2c3ebdb2d8a1488c81ac125159b13bbc
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spelling	oai:doaj.org-article:2c3ebdb2d8a1488c81ac125159b13bbc2021-11-25T18:11:43ZAssociation of Contemporary Statin Pretreatment Intensity and LDL-C Levels on the Incidence of STEMI Presentation10.3390/life111112682075-1729https://doaj.org/article/2c3ebdb2d8a1488c81ac125159b13bbc2021-11-01T00:00:00Zhttps://www.mdpi.com/2075-1729/11/11/1268https://doaj.org/toc/2075-1729Constituting hypolipidemic and pleiotropic effects, statins stabilize coronary artery plaque and may prevent STEMI events. This study investigated the association between contemporary statin pretreatment intensity, low-density lipoprotein cholesterol (LDL-C) levels, and the type of acute coronary syndrome (ACS) presentation: STEMI vs. NSTE-ACS. Data were drawn from the ACS Israeli Survey (ACSIS), a biennial prospective national survey that took place in 2008–2018. The rate of STEMI vs. NSTE-ACS was calculated by statin use, including statin intensity (high-intensity statin therapy (HIST) and low-intensity statin therapy (LIST) prior to the index ACS event. Among 5103 patients, 2839 (56%) were statin-naive, 1389 (27%) used LIST and 875 (17%) used HIST. Statin pretreated patients were older and had a higher rates of co-morbidities, cardiovascular disease history and pretreatment with evidence-based medications. STEMI vs. NSTE-ACS was lower among HIST vs. LIST vs. statin-naive patients (31.0%, 37.8%, and 54.0%, respectively, <i>p</i> for trend < 0.001). Multivariate analysis revealed that HIST was independently associated with lower STEMI presentation (OR<sub>adj</sub> 0.70; 95% CI 0.57–0.86), while LIST (OR<sub>adj</sub> 0.92; 95% CI 0.77–1.10) and LDL-C < 70 mg/dL (OR<sub>adj</sub> 0.96; 95% CI 0.82–1.14) were not. In conclusion, among patients admitted with ACS, pretreatment with HIST was independently associated with a lower probability of STEMI presentation, while LIST and LDL-C < 70 mg/dL were not.Ziv DadonMady MorielZaza IakobishviliElad AsherTal Y. SamuelDov GavishMichael GliksonShmuel GottliebMDPI AGarticleacute coronary syndromelow-density lipoprotein cholesterolmyocardial infarctionprimary preventionsecondary preventionstatinScienceQENLife, Vol 11, Iss 1268, p 1268 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	acute coronary syndrome low-density lipoprotein cholesterol myocardial infarction primary prevention secondary prevention statin Science Q
spellingShingle	acute coronary syndrome low-density lipoprotein cholesterol myocardial infarction primary prevention secondary prevention statin Science Q Ziv Dadon Mady Moriel Zaza Iakobishvili Elad Asher Tal Y. Samuel Dov Gavish Michael Glikson Shmuel Gottlieb Association of Contemporary Statin Pretreatment Intensity and LDL-C Levels on the Incidence of STEMI Presentation
description	Constituting hypolipidemic and pleiotropic effects, statins stabilize coronary artery plaque and may prevent STEMI events. This study investigated the association between contemporary statin pretreatment intensity, low-density lipoprotein cholesterol (LDL-C) levels, and the type of acute coronary syndrome (ACS) presentation: STEMI vs. NSTE-ACS. Data were drawn from the ACS Israeli Survey (ACSIS), a biennial prospective national survey that took place in 2008–2018. The rate of STEMI vs. NSTE-ACS was calculated by statin use, including statin intensity (high-intensity statin therapy (HIST) and low-intensity statin therapy (LIST) prior to the index ACS event. Among 5103 patients, 2839 (56%) were statin-naive, 1389 (27%) used LIST and 875 (17%) used HIST. Statin pretreated patients were older and had a higher rates of co-morbidities, cardiovascular disease history and pretreatment with evidence-based medications. STEMI vs. NSTE-ACS was lower among HIST vs. LIST vs. statin-naive patients (31.0%, 37.8%, and 54.0%, respectively, <i>p</i> for trend < 0.001). Multivariate analysis revealed that HIST was independently associated with lower STEMI presentation (OR<sub>adj</sub> 0.70; 95% CI 0.57–0.86), while LIST (OR<sub>adj</sub> 0.92; 95% CI 0.77–1.10) and LDL-C < 70 mg/dL (OR<sub>adj</sub> 0.96; 95% CI 0.82–1.14) were not. In conclusion, among patients admitted with ACS, pretreatment with HIST was independently associated with a lower probability of STEMI presentation, while LIST and LDL-C < 70 mg/dL were not.
format	article
author	Ziv Dadon Mady Moriel Zaza Iakobishvili Elad Asher Tal Y. Samuel Dov Gavish Michael Glikson Shmuel Gottlieb
author_facet	Ziv Dadon Mady Moriel Zaza Iakobishvili Elad Asher Tal Y. Samuel Dov Gavish Michael Glikson Shmuel Gottlieb
author_sort	Ziv Dadon
title	Association of Contemporary Statin Pretreatment Intensity and LDL-C Levels on the Incidence of STEMI Presentation
title_short	Association of Contemporary Statin Pretreatment Intensity and LDL-C Levels on the Incidence of STEMI Presentation
title_full	Association of Contemporary Statin Pretreatment Intensity and LDL-C Levels on the Incidence of STEMI Presentation
title_fullStr	Association of Contemporary Statin Pretreatment Intensity and LDL-C Levels on the Incidence of STEMI Presentation
title_full_unstemmed	Association of Contemporary Statin Pretreatment Intensity and LDL-C Levels on the Incidence of STEMI Presentation
title_sort	association of contemporary statin pretreatment intensity and ldl-c levels on the incidence of stemi presentation
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/2c3ebdb2d8a1488c81ac125159b13bbc
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Association of Contemporary Statin Pretreatment Intensity and LDL-C Levels on the Incidence of STEMI Presentation

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