Many patients discontinue statin after acute myocardial infarction (AMI) despite its
necessity. However, limited data are available describing the clinical impact of statin
withdrawal after AMI. This study enrolled 3,807 patients in the Korean multicenter
registry who survived for 1 year after AMI. All patients were prescribed statin at
discharge and were divided into 2 groups on the basis of statin withdrawal history;
603 patients had a history of statin discontinuation and 3,204 patients continued
statin therapy. The primary outcome was mortality from any cause. We also analyzed
the incidence of cardiac death, nonfatal myocardial infarction, any revascularization,
and stroke. The duration of follow-up was 4 years after AMI. Statin withdrawal was
associated with higher mortality than continued statin treatment (hazard ratio 3.45,
95% confidence interval 2.81 to 4.24, p <0.001), primarily as the result of increased
cardiac mortality (hazard ratio 4.65, 95% confidence interval 3.14 to 6.87, p <0.001).
However, the incidences of nonfatal myocardial infarction, any revascularization,
and stroke were not different between the groups. Analysis by propensity score matching
did not affect the results. In conclusion, many patients experienced statin withdrawal
after AMI, which significantly increased long-term mortality in the present study.
Careful education and monitoring are needed to reduce adverse cardiac outcomes in
patients after AMI.
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Article info
Publication history
Published online: October 11, 2014
Accepted:
September 23,
2014
Received in revised form:
September 23,
2014
Received:
August 15,
2014
Footnotes
This work was supported by grants of these organizations: 1) National Research Foundation (NRF) of Korea funded by Ministry of Education, Science and Technology (MEST) of the Korean Government, Republic of Korea (grant number 2010-0020261), and 2) Korea Healthcare Technology R&D Project, Ministry of Health and Welfare, Republic of Korea (grant numbers HI12C0275, HI12C0199, and HI13C1527).
See page 6 for disclosure information.
Drs Kiyuk Chang and Youngkeun Ahn have contributed equally to this article.
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© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
