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AS-104: Impact of Statins 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) 1,690 [61.2%], p ⫽ 0.014] were noted in the LMCA group. At 12 months, although major clinical outcomes, including mortality and repeat PCI, were similar between the 2 groups, there was a trend toward a higher incidence of total major adverse cardiac events (MACE) in the LMCA group. Furthermore, target lesion revascularization (TLR), any recurrent acute MI, and recurrent NSTEMI were significantly higher in patients in the LMCA group after the multivariate analysis (Table).
0.487; 95% confidence interval, 0.377– 0.628; p ⬍0.01; PS-adjusted odds ratio, 0.599; 95% confidence interval, 0.445– 0.806; p ⫽ 0.001).
Table. Twelve-Month Clinical Outcomes (on Multivariate Analysis)
Conclusion: Routine administration of statins in patients with acute NSTEMI, regardless of the revascularization strategy, showed better 12-month clinical outcomes compared with those of NSTEMI patients without statin therapy.
AS-105
Conclusion: The prevalence of LMCA disease was in lower proportion (3.43%) in the acute NSTEMI setting but showed worse 1-year major clinical outcomes because of a higher number of TLR and cumulative recurrent NSTEMI in the LMCA disease group at 1 year.
AS-104
EP O S T E R A B S T R A C T S
Impact of Statins on 12-Month Clinical Outcomes in Patients with Acute Non–ST-Segment Elevation Myocardial Infarction. Seung-Woon Rha1, 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, Ji Won Kim1, Eung Ju Kim1, Chang Gyu Park1, Hong Seog Seo1, Dong Joo Oh1, Young Keun Ahn2, Myung Ho Jeong2, KAMIR Investigators3. 1Korea University Guro Hospital, Seoul, Republic of Korea; 2Chonnam National University Hospital, Gwangju, Republic of Korea; 3Other KAMIR, investigators, Korea (Republic of). Background: There are very limited data on the role of statins in managing patients with acute non–ST-segment elevation myocardial infarction (NSTEMI), especially in the drug-eluting stent era. Methods: The study population consisted of 2,425 consecutive patients with acute NSTEMI enrolled in the Korea Acute Myocardial Infarction Registry (KAMIR) study from November 2005 to April 2008. Statin administration, types, and doses were at the physician’s discretion, and 1,805 patients were included from the time of presentation. We investigated the clinical outcomes using propensity score (PS) adjustment between 1,805 statin-naive patients and those without statin treatment (n ⫽ 620) up to 12 months. Results: The baseline characteristics were similar between the 2 groups, except for fewer patients with diabetes mellitus in the statin group (31.0% vs 35.5%, p ⫽ 0.038). Mortality, repeat percutaneous coronary intervention (predominantly derived by fewer non–target vessel revascularizations), recurrent acute MI, and total major adverse cardiac events (MACE) were significantly lower in the statin group (Table). Statin administration was associated with a lower incidence of MACE at 12 months (Unadjusted odds ratio,
Preprocedural Neutrophilia with Anemia Is an Independent Predictor of Short-Term Clinical Outcomes After Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction. Kyung Hoon Cho, Myung Ho Jeong, Keun-Ho Park, Min Goo Lee, Jum Suk Ko, Doo Sun Sim, Nam Sik Yoon, Hyun Ju Yoon, Young Joon Hong, Hyung Wook Park, Ju Han Kim, Young Keun Ahn, Jeong Gwan Cho, Jong Chun Park, Jung Chaee Kang. Chonnam National University Hospital, Gwangju, Republic of Korea. Background: This study examined the significance of preprocedural neutrophilia with anemia in the clinical outcomes after percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI). Methods: We analyzed data from 699 eligible patients undergoing a 1-year follow-up after PCI for STEMI from Oct 2005 and Jan 2008. The study population was categorized according to the neutrophil count (the 1st, 2nd and 3rd tertile; ⬍6,260, 6260-9499 and ⱖ9,500/mm3) and hemoglobin level (Hb ⱖ12, 10 ⱕ Hb ⬍ 12 and Hb ⬍ 10) on admission. For the evaluation of the prognostic value of neutrophilia with anemia for clinical outcomes, we scored the patients one after the other according to the neutrophil count (the 1st, 2nd and 3rd tertile; 0, 1 and 2) and hemogolin level (Hb ⱖ 12, 10 ⱕ Hb ⬍ 12 and Hb ⬍ 10 mg/dL; 0, 1 and 2). And, total patients were divided into five groups based on the sum of each score (0, group I, n ⫽ 178; 1, group II, n ⫽ 225; 2 group III, n ⫽ 236; 3, group IV, n ⫽ 40; 4, group V, n ⫽ 20). Results: The mean values of neutrophil count and hemoglobin level were 8490 ⫾ 3860/mm3 and 13.61 ⫾ 1.94 mg/dL respectively. Patients with neutrophil count in the third tertile did not have significant higher 1-month composite cardiac events (7% vs 9%, p ⫽ 0.520) and 12-month death (10% vs 9%, p ⫽ 0.973) compared with those with neutropil count in the first tertile. But, patients with hemoblobin level ⬍ 10 mg/dL had significant higher 1-month composite cardiac events (6% vs 28%, p ⬍ 0.001) and 12-month death (6% vs 30%, p ⬍ 0.001) compared with those with hemoglobin level ⱖ 12 mg/dL. Also, group IV and V had significant higher 1-month major cardiac events (6% vs. 25% vs. 35%, p ⬍ 0.001) and 12-month death (8 vs. 30% vs. 35%, p ⬍ 0.001) compared with group I. In a multivariable setting, the coexistence of preprocedural neutrophil count in the third tertile and hemoglobin level less than 10 mg/dL were independent predictors of 1-month major adverse cardiac events (OR, 4.46; 95% CI, 1.22216.271; P ⫽ 0.024), but not of 12-month mortality.
44B The American Journal of Cardiology姞 APRIL 28 –30 2010 ANGIOPLASTY SUMMIT ABSTRACTS/E-Poster
0.487; 95% confidence interval, 0.377– 0.628; p ⬍0.01; PS-adjusted odds ratio, 0.599; 95% confidence interval, 0.445– 0.806; p ⫽ 0.001).
Table. Twelve-Month Clinical Outcomes (on Multivariate Analysis)
Conclusion: Routine administration of statins in patients with acute NSTEMI, regardless of the revascularization strategy, showed better 12-month clinical outcomes compared with those of NSTEMI patients without statin therapy.
AS-105
Conclusion: The prevalence of LMCA disease was in lower proportion (3.43%) in the acute NSTEMI setting but showed worse 1-year major clinical outcomes because of a higher number of TLR and cumulative recurrent NSTEMI in the LMCA disease group at 1 year.
AS-104
EP O S T E R A B S T R A C T S
Impact of Statins on 12-Month Clinical Outcomes in Patients with Acute Non–ST-Segment Elevation Myocardial Infarction. Seung-Woon Rha1, 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, Ji Won Kim1, Eung Ju Kim1, Chang Gyu Park1, Hong Seog Seo1, Dong Joo Oh1, Young Keun Ahn2, Myung Ho Jeong2, KAMIR Investigators3. 1Korea University Guro Hospital, Seoul, Republic of Korea; 2Chonnam National University Hospital, Gwangju, Republic of Korea; 3Other KAMIR, investigators, Korea (Republic of). Background: There are very limited data on the role of statins in managing patients with acute non–ST-segment elevation myocardial infarction (NSTEMI), especially in the drug-eluting stent era. Methods: The study population consisted of 2,425 consecutive patients with acute NSTEMI enrolled in the Korea Acute Myocardial Infarction Registry (KAMIR) study from November 2005 to April 2008. Statin administration, types, and doses were at the physician’s discretion, and 1,805 patients were included from the time of presentation. We investigated the clinical outcomes using propensity score (PS) adjustment between 1,805 statin-naive patients and those without statin treatment (n ⫽ 620) up to 12 months. Results: The baseline characteristics were similar between the 2 groups, except for fewer patients with diabetes mellitus in the statin group (31.0% vs 35.5%, p ⫽ 0.038). Mortality, repeat percutaneous coronary intervention (predominantly derived by fewer non–target vessel revascularizations), recurrent acute MI, and total major adverse cardiac events (MACE) were significantly lower in the statin group (Table). Statin administration was associated with a lower incidence of MACE at 12 months (Unadjusted odds ratio,
Preprocedural Neutrophilia with Anemia Is an Independent Predictor of Short-Term Clinical Outcomes After Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction. Kyung Hoon Cho, Myung Ho Jeong, Keun-Ho Park, Min Goo Lee, Jum Suk Ko, Doo Sun Sim, Nam Sik Yoon, Hyun Ju Yoon, Young Joon Hong, Hyung Wook Park, Ju Han Kim, Young Keun Ahn, Jeong Gwan Cho, Jong Chun Park, Jung Chaee Kang. Chonnam National University Hospital, Gwangju, Republic of Korea. Background: This study examined the significance of preprocedural neutrophilia with anemia in the clinical outcomes after percutaneous coronary intervention (PCI) in patients with ST-elevation myocardial infarction (STEMI). Methods: We analyzed data from 699 eligible patients undergoing a 1-year follow-up after PCI for STEMI from Oct 2005 and Jan 2008. The study population was categorized according to the neutrophil count (the 1st, 2nd and 3rd tertile; ⬍6,260, 6260-9499 and ⱖ9,500/mm3) and hemoglobin level (Hb ⱖ12, 10 ⱕ Hb ⬍ 12 and Hb ⬍ 10) on admission. For the evaluation of the prognostic value of neutrophilia with anemia for clinical outcomes, we scored the patients one after the other according to the neutrophil count (the 1st, 2nd and 3rd tertile; 0, 1 and 2) and hemogolin level (Hb ⱖ 12, 10 ⱕ Hb ⬍ 12 and Hb ⬍ 10 mg/dL; 0, 1 and 2). And, total patients were divided into five groups based on the sum of each score (0, group I, n ⫽ 178; 1, group II, n ⫽ 225; 2 group III, n ⫽ 236; 3, group IV, n ⫽ 40; 4, group V, n ⫽ 20). Results: The mean values of neutrophil count and hemoglobin level were 8490 ⫾ 3860/mm3 and 13.61 ⫾ 1.94 mg/dL respectively. Patients with neutrophil count in the third tertile did not have significant higher 1-month composite cardiac events (7% vs 9%, p ⫽ 0.520) and 12-month death (10% vs 9%, p ⫽ 0.973) compared with those with neutropil count in the first tertile. But, patients with hemoblobin level ⬍ 10 mg/dL had significant higher 1-month composite cardiac events (6% vs 28%, p ⬍ 0.001) and 12-month death (6% vs 30%, p ⬍ 0.001) compared with those with hemoglobin level ⱖ 12 mg/dL. Also, group IV and V had significant higher 1-month major cardiac events (6% vs. 25% vs. 35%, p ⬍ 0.001) and 12-month death (8 vs. 30% vs. 35%, p ⬍ 0.001) compared with group I. In a multivariable setting, the coexistence of preprocedural neutrophil count in the third tertile and hemoglobin level less than 10 mg/dL were independent predictors of 1-month major adverse cardiac events (OR, 4.46; 95% CI, 1.22216.271; P ⫽ 0.024), but not of 12-month mortality.
44B The American Journal of Cardiology姞 APRIL 28 –30 2010 ANGIOPLASTY SUMMIT ABSTRACTS/E-Poster