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CLINICAL STUDY: PERCUTANEOUS CORONARY INTERVENTION

Statin treatment following coronary artery stenting and one-year survival

Albert Schömig, MD^*,*, Julinda Mehilli, MD^*, Heidrun Holle, RN^*, Karin Hösl, RN^*, Dorejd Kastrati^*, J.ürgen Pache, MD, Melchior Seyfarth, MD, Franz-Josef Neumann, MD, Josef Dirschinger, MD and Adnan Kastrati, MD^*

^* Deutsches Herzzentrum, Munich, Germany
1. Medizinische Klinik rechts der Isar, Technische Universität, Munich, Germany

Manuscript received November 28, 2001; revised manuscript received March 26, 2002, accepted June 4, 2002.

^* Reprint requests and correspondence: Dr. Albert Schömig, Deutsches Herzzentrum, Lazarettstr. 36, 80636 München, Germany.
aschoemig{at}dhm.mhn.de

OBJECTIVES: We assessed the influence of statin therapy given after the procedure on one-year survival of patients treated with coronary artery stenting.

BACKGROUND: Coronary artery stenting is currently a common treatment option for patients with symptomatic coronary artery disease (CAD). Although several secondary prevention trials have demonstrated improved survival achieved with statin therapy in conservatively treated patients with CAD, it is not known whether this benefit can also be expected in patients undergoing percutaneous coronary interventions with intraluminal stenting.

METHODS: This study included 4,520 patients younger than 80 years who underwent coronary artery stenting and were discharged from the hospital in the period October 1995 through September 1999. We compared one-year mortality of 3,585 patients who received statins after stenting with that of 935 patients who did not.

RESULTS: The mortality rate at one year was 2.6% among patients who received statins and 5.6% among those who did not. Thus, statin therapy at discharge was associated with an unadjusted odds ratio (OR) of 0.46 (95% confidence interval [CI], 0.33 to 0.65), indicating a 54% reduction in the risk of death at one year. After adjusting for other covariates, the risk reduction associated with statin therapy was 49%, OR 0.51 (95% CI, 0.36 to 0.71). This reduction was observable in most of the subgroups of patients.

CONCLUSIONS: The results of this nonrandomized study show that statin therapy improves survival after coronary artery stenting independent of patient characteristics recorded on the day of the intervention.

Abbreviations and Acronyms   ACE   angiotensin-converting enzyme   CAD   coronary artery disease   CI   confidence interval   LV   left ventricular   MI   myocardial infarction   OR   odds ratio   PCI   percutaneous coronary intervention   PTCA   percutaneous transluminal coronary angioplasty

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