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AS-87: The Influence of Prior Myocardial Infarction on 12-Month Clinical Outcomes in Patients with Acute Non–ST-Segment Elevation Myocardial Infarction
Wednesday, April 28 - Friday, April 30, 2010 (E-Poster Abstract Zone)
AS-87 The Influence of Prior Myocardial Infarction on 12-Month Clinical Outcomes in Patients with Acute Non–ST-Segment Elevation Myocardial Infarction. Seung-Woon Rha1, Young Keun Ahn2, Lin Wang1, Ji Young Park1, Kanhaiya L. Poddar1, Sureshkumar Ramasamy1, Byoung Geol Choi1, Ji Bak Kim1, Seung Yong Shin1, Cheol Ung Choi1, Hong Euy Lim1, Jin Won Kim1, Eung Ju Kim1, Chang Gyu Park1, Hong Seog Seo1, Dong Joo Oh1, Myung Ho Jeong2, KAMIR Investigators3. 1Korea University Guro Hospital, Seoul, Republic of Korea; 2Cardiovascular Center, Chon Nam National University Hospital, Gwangju, Republic of Korea; 3 Other KAMIR Investigators, Republic of Korea. Background: There are very limited data on the influences of previous myocardial infarction (MI) on the outcomes of patients with recurrent acute non–ST-segment elevation MI (re-NSTEMI), especially after primary percutaneous coronary intervention (PCI) in the drug-eluting stent era. Methods: The current data came from the Korea Acute Myocardial Infarction Registry (KAMIR) study that consisted of 4,121 consecutive patients with acute NSTEMI enrolled from November 2005 to April 2008. Among them, 492 (11.94%) patients presented with recurrent AMI (NSTEMI) with a previous history of MI. We compared the clinical outcomes of re-AMI patients who presented as NSTEMI with those of first-onset NSTEMI (first-AMI group, n ⫽ 3,629) at 12 months. Results: The baseline characteristics are largely unfavorable in re-MI group compared with the first-AMI group. At 12 months, although the incidence of repeat PCI was similar between the groups, mortality, recurrent AMI (primarily due to increased NSTEMI), and major adverse cardiac events (MACE) were higher in the re-AMI group compared with those in the first-AMI group (Table). Previous MI was an independent predictor of MACE at 12 months in the re-AMI group (unadjusted odds ratio, 1.771; 95% confidence interval, 1.378 –2.276; p ⬍0.001), even after adjusting for many confounding variables (adjusted odds ratio, 1.503; 95% confidence interval, 1.084 –2.086; p ⫽ 0.015).
Conclusion: Patients with acute NSTEMI with previous MI presented with worse baseline clinical and procedural characteristics and were more associated with worse major clinical outcomes up to 12 months compared with those of first-onset NSTEMI patients.
AS-88 Efficacy and Safety of Pitavastatin (Livalo) in Patients with Acute ST-Segment Elevation Myocardial Infarction: 12-Month Follow-Up Data from the Livalo Acute Myocardial Infarction Study (LAMIS). Seung-Woon Rha. Lin Wang1, Ji Young Park1, Kanhaiya L. Poddar1, Sureshkumar Ramasamy1, Byoung Geol Choi1, Ji Bak Kim1, Seung Yong Shin1, Cheol Ung Choi1, Hong Euy Lim1, Jin Won Kim1, Eung Ju Kim1, Chang Gyu Park1, Hong Seog Seo1, Dong Joo Oh1, Young Keun Ahn2, Myung Ho Jeong2, LAMIS Investigators3. 1Korea University Guro Hospital, Seoul, Korea (Republic of); 2Chon Nam National University Hospital, Gwangju, Korea (Republic of); 3Other LAMIS, investigators, Korea (Republic of). Background: Pitavastatin (Livalo) is a potent lipophilic statin and may play an important role in the acute myocardial infarction (AMI) setting, not only by reducing low-density lipoprotein cholesterol, but also through the pleiotrophic effects. However, there have been limited data on the role of pitavastatin in managing patients with acute ST-segment elevation myocardial infarction (STEMI), especially in the drug-eluting stent era. Methods: The study originated from the Livalo AMI study (LAMIS), which exclusively used pitavastatin (2 mg/day as the sole statin therapy from time of presentation), and from the Korea AMI Registry (KAMIR) with patients who enrolled from April 2007 to March 25, 2009 as historical comparison data. We compared the clinical outcomes using propensity score adjustment between the STEMI patients treated with pitavastatin (n ⫽ 411) and without statin therapy from KAMIR (n ⫽ 376) up to 12 months. Results: The baseline characteristics were similar between the 2 groups, except that patients in the pitavastatin group were younger than those in the no-statin group (age, 59.9 ⫾ 12.6 years vs 62.2 ⫾ 12.6 years; p ⬍0.05), whereas past medication was unfavorable in the pitavastatin group (p ⬍0.05). Although the incidence of target lesion and vessel revascularization and recurrent AMI was similar between the 2 groups, cardiac mortality, repeat percutaneous coronary intervention (primarily by reduced nontarget vessel revascularization), and total major adverse cardiac events (MACE) were significantly lower in the pitavastatin group (Table). Pitavastatin administration was associated with a lower incidence of MACE at 12 months (odds ratio, 0.463; 95% confidence interval, 0.276 – 0.776; p ⫽ 0.003).
Conclusion: Routine administration of 2 mg/day pitavastatin in STEMI patients showed better clinical outcomes compared with those of STEMI patients without statin therapy up to 12 months.
The American Journal of Cardiology姞 APRIL 28 –30 2010 ANGIOPLASTY SUMMIT ABSTRACTS/E-Poster 37B
EP O S T E R A B S T R A C T S
AS-87 The Influence of Prior Myocardial Infarction on 12-Month Clinical Outcomes in Patients with Acute Non–ST-Segment Elevation Myocardial Infarction. Seung-Woon Rha1, Young Keun Ahn2, Lin Wang1, Ji Young Park1, Kanhaiya L. Poddar1, Sureshkumar Ramasamy1, Byoung Geol Choi1, Ji Bak Kim1, Seung Yong Shin1, Cheol Ung Choi1, Hong Euy Lim1, Jin Won Kim1, Eung Ju Kim1, Chang Gyu Park1, Hong Seog Seo1, Dong Joo Oh1, Myung Ho Jeong2, KAMIR Investigators3. 1Korea University Guro Hospital, Seoul, Republic of Korea; 2Cardiovascular Center, Chon Nam National University Hospital, Gwangju, Republic of Korea; 3 Other KAMIR Investigators, Republic of Korea. Background: There are very limited data on the influences of previous myocardial infarction (MI) on the outcomes of patients with recurrent acute non–ST-segment elevation MI (re-NSTEMI), especially after primary percutaneous coronary intervention (PCI) in the drug-eluting stent era. Methods: The current data came from the Korea Acute Myocardial Infarction Registry (KAMIR) study that consisted of 4,121 consecutive patients with acute NSTEMI enrolled from November 2005 to April 2008. Among them, 492 (11.94%) patients presented with recurrent AMI (NSTEMI) with a previous history of MI. We compared the clinical outcomes of re-AMI patients who presented as NSTEMI with those of first-onset NSTEMI (first-AMI group, n ⫽ 3,629) at 12 months. Results: The baseline characteristics are largely unfavorable in re-MI group compared with the first-AMI group. At 12 months, although the incidence of repeat PCI was similar between the groups, mortality, recurrent AMI (primarily due to increased NSTEMI), and major adverse cardiac events (MACE) were higher in the re-AMI group compared with those in the first-AMI group (Table). Previous MI was an independent predictor of MACE at 12 months in the re-AMI group (unadjusted odds ratio, 1.771; 95% confidence interval, 1.378 –2.276; p ⬍0.001), even after adjusting for many confounding variables (adjusted odds ratio, 1.503; 95% confidence interval, 1.084 –2.086; p ⫽ 0.015).
Conclusion: Patients with acute NSTEMI with previous MI presented with worse baseline clinical and procedural characteristics and were more associated with worse major clinical outcomes up to 12 months compared with those of first-onset NSTEMI patients.
AS-88 Efficacy and Safety of Pitavastatin (Livalo) in Patients with Acute ST-Segment Elevation Myocardial Infarction: 12-Month Follow-Up Data from the Livalo Acute Myocardial Infarction Study (LAMIS). Seung-Woon Rha. Lin Wang1, Ji Young Park1, Kanhaiya L. Poddar1, Sureshkumar Ramasamy1, Byoung Geol Choi1, Ji Bak Kim1, Seung Yong Shin1, Cheol Ung Choi1, Hong Euy Lim1, Jin Won Kim1, Eung Ju Kim1, Chang Gyu Park1, Hong Seog Seo1, Dong Joo Oh1, Young Keun Ahn2, Myung Ho Jeong2, LAMIS Investigators3. 1Korea University Guro Hospital, Seoul, Korea (Republic of); 2Chon Nam National University Hospital, Gwangju, Korea (Republic of); 3Other LAMIS, investigators, Korea (Republic of). Background: Pitavastatin (Livalo) is a potent lipophilic statin and may play an important role in the acute myocardial infarction (AMI) setting, not only by reducing low-density lipoprotein cholesterol, but also through the pleiotrophic effects. However, there have been limited data on the role of pitavastatin in managing patients with acute ST-segment elevation myocardial infarction (STEMI), especially in the drug-eluting stent era. Methods: The study originated from the Livalo AMI study (LAMIS), which exclusively used pitavastatin (2 mg/day as the sole statin therapy from time of presentation), and from the Korea AMI Registry (KAMIR) with patients who enrolled from April 2007 to March 25, 2009 as historical comparison data. We compared the clinical outcomes using propensity score adjustment between the STEMI patients treated with pitavastatin (n ⫽ 411) and without statin therapy from KAMIR (n ⫽ 376) up to 12 months. Results: The baseline characteristics were similar between the 2 groups, except that patients in the pitavastatin group were younger than those in the no-statin group (age, 59.9 ⫾ 12.6 years vs 62.2 ⫾ 12.6 years; p ⬍0.05), whereas past medication was unfavorable in the pitavastatin group (p ⬍0.05). Although the incidence of target lesion and vessel revascularization and recurrent AMI was similar between the 2 groups, cardiac mortality, repeat percutaneous coronary intervention (primarily by reduced nontarget vessel revascularization), and total major adverse cardiac events (MACE) were significantly lower in the pitavastatin group (Table). Pitavastatin administration was associated with a lower incidence of MACE at 12 months (odds ratio, 0.463; 95% confidence interval, 0.276 – 0.776; p ⫽ 0.003).
Conclusion: Routine administration of 2 mg/day pitavastatin in STEMI patients showed better clinical outcomes compared with those of STEMI patients without statin therapy up to 12 months.
The American Journal of Cardiology姞 APRIL 28 –30 2010 ANGIOPLASTY SUMMIT ABSTRACTS/E-Poster 37B
EP O S T E R A B S T R A C T S