BACKGROUND There is insufficient evidence regarding the effect of high-intensity statin therapy in older adults.This study aimed to investigate the effects of high-intensity statin treatment on the clinical outcomes i...BACKGROUND There is insufficient evidence regarding the effect of high-intensity statin therapy in older adults.This study aimed to investigate the effects of high-intensity statin treatment on the clinical outcomes in older adults with myocardial infarc-tion(MI).METHODS Consecutive patients with MI aged at least 75 years were analyzed retrospectively.The primary endpoint was major adverse cardiac and cerebrovascular events(MACCE),defined as a composite of all-cause death,MI,rehospitalization due to un-stable angina,repeat revascularization,and ischemic stroke.The high-intensity group was compared to the low-to-moderate in-tensity group in the propensity score-matched cohort.RESULTS Average age of total 546 patients was 81 years.Among them,84%of patients underwent percutaneous coronary in-tervention.The unadjusted seven-year MACCE rate differed by statin intensity(high-intensity statin group:38%,moderate-intensity statin group:42%,low-intensity statin group:56%,and no-statin group:61%,P=0.004).However,among these groups,many baseline characteristics were significantly different.Among the 74 propensity score-matched pairs,which lacked any significant differences in all baseline characteristics,the high-intensity group had a significantly lower rate of MACCE than the low-to-moderate intensity group(37%vs.53%,P=0.047).Follow-up low-density lipoprotein cholesterol levels were significantly lower in the high-intensity group than that in the low-to-moderate intensity group(69.4±16.0 mg/dL vs.77.9±25.9 mg/dL,P=0.026).CONCLUSIONS In older adult patients with MI,the use of high-intensity statin caused significantly less occurrence of MACCE in comparison to that in low-to-moderate intensity for up to seven years of follow-up.展开更多
Background The zotarolimus-eluting stent has shown larger in-stent late lumen loss compared to sirolimus-eluting stents in previous studies. However, this has not been thoroughly evaluated in ST elevation myocardial i...Background The zotarolimus-eluting stent has shown larger in-stent late lumen loss compared to sirolimus-eluting stents in previous studies. However, this has not been thoroughly evaluated in ST elevation myocardial infarction. Methods This was a prospective, randomized, controlled trial evaluating angiographic outcomes in patients presenting with ST elevation myocardial infarction, treated with zotarolimus-eluting stents or sirolimus-eluting stents. From March 2007 to February 2009, 122 patients were randomized to zotarolimus-eluting stents or sirolimus-eluting stents in a 1：1 fashion. The primary endpoint was 9-month in-stent late lumen loss confirmed by coronary angiography, and secondary endpoints were percent diameter stenosis, binary restenosis rate, major adverse cardiac events （a composite of cardiac death, non-fatal myocardial infarction, and target vessel revascularization）, and late-acquired incomplete stent apposition. Results Angiographic in-stent late lumen loss was significantly higher in the zotarolimus-eluting stent group compared to the sirolimus-eluting stent group （（0.49±0.65） mm vs. （0.10±0.46） mm, P=0.001）. Percent diameter stenosis at 9-month follow-up was also larger in the zotarolimus-eluting stent group （（30.0±17.9）% vs. （17.6±14.0）%, P 〈0.001）. In-segment analysis showed similar findings. There were no significant differences in binary restenosis rate, major adverse cardiac events, and late-acquired incomplete stent apposition. Conclusions Compared to sirolimus-eluting stents, the zotarolimus-eluting stent is associated with significantly higher in-stent late lumen loss at 9-month angiographic follow-up in the treatment of ST elevation myocardial infarction. Although there was no significant difference in 1-year clinical outcomes, the clinical implication of increased late lumen loss should be further studied.展开更多
文摘BACKGROUND There is insufficient evidence regarding the effect of high-intensity statin therapy in older adults.This study aimed to investigate the effects of high-intensity statin treatment on the clinical outcomes in older adults with myocardial infarc-tion(MI).METHODS Consecutive patients with MI aged at least 75 years were analyzed retrospectively.The primary endpoint was major adverse cardiac and cerebrovascular events(MACCE),defined as a composite of all-cause death,MI,rehospitalization due to un-stable angina,repeat revascularization,and ischemic stroke.The high-intensity group was compared to the low-to-moderate in-tensity group in the propensity score-matched cohort.RESULTS Average age of total 546 patients was 81 years.Among them,84%of patients underwent percutaneous coronary in-tervention.The unadjusted seven-year MACCE rate differed by statin intensity(high-intensity statin group:38%,moderate-intensity statin group:42%,low-intensity statin group:56%,and no-statin group:61%,P=0.004).However,among these groups,many baseline characteristics were significantly different.Among the 74 propensity score-matched pairs,which lacked any significant differences in all baseline characteristics,the high-intensity group had a significantly lower rate of MACCE than the low-to-moderate intensity group(37%vs.53%,P=0.047).Follow-up low-density lipoprotein cholesterol levels were significantly lower in the high-intensity group than that in the low-to-moderate intensity group(69.4±16.0 mg/dL vs.77.9±25.9 mg/dL,P=0.026).CONCLUSIONS In older adult patients with MI,the use of high-intensity statin caused significantly less occurrence of MACCE in comparison to that in low-to-moderate intensity for up to seven years of follow-up.
文摘Background The zotarolimus-eluting stent has shown larger in-stent late lumen loss compared to sirolimus-eluting stents in previous studies. However, this has not been thoroughly evaluated in ST elevation myocardial infarction. Methods This was a prospective, randomized, controlled trial evaluating angiographic outcomes in patients presenting with ST elevation myocardial infarction, treated with zotarolimus-eluting stents or sirolimus-eluting stents. From March 2007 to February 2009, 122 patients were randomized to zotarolimus-eluting stents or sirolimus-eluting stents in a 1：1 fashion. The primary endpoint was 9-month in-stent late lumen loss confirmed by coronary angiography, and secondary endpoints were percent diameter stenosis, binary restenosis rate, major adverse cardiac events （a composite of cardiac death, non-fatal myocardial infarction, and target vessel revascularization）, and late-acquired incomplete stent apposition. Results Angiographic in-stent late lumen loss was significantly higher in the zotarolimus-eluting stent group compared to the sirolimus-eluting stent group （（0.49±0.65） mm vs. （0.10±0.46） mm, P=0.001）. Percent diameter stenosis at 9-month follow-up was also larger in the zotarolimus-eluting stent group （（30.0±17.9）% vs. （17.6±14.0）%, P 〈0.001）. In-segment analysis showed similar findings. There were no significant differences in binary restenosis rate, major adverse cardiac events, and late-acquired incomplete stent apposition. Conclusions Compared to sirolimus-eluting stents, the zotarolimus-eluting stent is associated with significantly higher in-stent late lumen loss at 9-month angiographic follow-up in the treatment of ST elevation myocardial infarction. Although there was no significant difference in 1-year clinical outcomes, the clinical implication of increased late lumen loss should be further studied.
