Beneficial Effects of Statin Therapy in Acute Myocardial Infarction Patients with Presenting Atrial Fibrillation

概要

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Methods: 559 AMI patients who were enrolled in Korea AMI registry (KAMIR) and presented with AF on EKG at arrival in the emergency room were divided into two groups; statin group (n=364) or control group (n=195). We evaluated the effects of statin therapy on MACE including all-cause death, re-infarction, coronary artery bypass grafting, heart failure requiring re-hospitalization, and target lesion revascularization during inhospital period and one-year clinical follow-up. Results: The baseline clinical characteristics were similar between the two groups including hemodynamic parameters, killip class, risk factor of atherosclerosis, EKG and echocardiographic, and coronary angiographic findings. The baseline level of LDL cholesterol was higher in statin treatment group than control group (107.9 mg/dl vs. 96.8 mg/dl, p=0.003). The rate of in-hospital death was significantly lower in statin treatment group (5.5% vs. 23.8%, p<0.001). The incidence rate of MACE during one-year clinical follow-up was significantly lower in statin treatment group (11.8% vs. 27.7%, p<0.001). Multivariate Cox regression analysis revealed that statin therapy (P=0.015, hazard ratio: 0.51; 95% confidence interval: 0.31–0.85) was a significant predictor of favorable prognosis. Conclusion: Statin therapy was beneficial for long-term outcome of AMI patients with AF.