The Prognostic Significance of Statin Therapy According to the Level of C-Reactive Protein in Acute Myocardial Infarction Patients who Underwent Percutaneous Coronary Intervention

ABSTRACT

BACKGROUND AND OBJECTIVES: As well as lowering lipids, statins are known to possess antiinflammatory and antithrombotic properties. Recent studies have suggested an association between statins and the early reduction in deaths, or myocardial infarction following percutaneous coronary intervention (PCI). The aim of this study was to examine the interrelationship between inflammation, statin use and PCI outcomes in patients with an acute myocardial infarction (AMI). SUBJECTS AND METHODS: A total of 340 patients with AMI, who underwent PCI between June 2000 and Dec 2001 at Chonnam National University Hospital, were divided into two groups Group I (n= 158, 58.9+/-10.7 years, male 82.9%) those with normal C-reactive protein (CRP) ( or =0.5 mg/dL, mean value=3.71+/-1.73 mg/dL) on admission. RESULTS: The levels of the erythrocyte sedimentation rate, white blood cell, monocyte, creatine kinase (CK), CK-MB and troponin I and T were higher in Group II than in Group I. Severe coronary lesions (type B2/C lesion), according to American College of Cardiology/American Heart Association, were more frequently observed in Group II than in Group I. During the one year clinical follow up, major adverse cardiac events (MACE) occurred significantly more frequently in those patients with elevated CRP levels without statin therapy. Using a multiple logistic regression analysis, the independent predictors for the one year MACE were a CRP above 0.5 mg/dl, a left ventricular ejection fraction less than 40%, an age above 75 years, statin use and a type B2/C lesion on the coronary angiogram (p<0.001, =0.001, 0.002, 0.031 and 0.035, respectively). CONCLUSION: Statin therapy significantly attenuates the increased risk for MACE in AMI patients, with elevated CRP levels, undergoing PCI.