Statin therapy within 24 hours of hospital admission associatedwith lower risk of CHF and in-hospital death

Early statin use was associated with a lower risk of congestive heart failure (CHF) development and in-hospital death in patients treated for acute myocardial infarction (AMI), according to a recent observational study published in the International Journal of Cardiology.

The authors believe that this is the first study to demonstrate a reduced risk of CHF associated with early statin therapy in AMI patients and that this is the first data on mechanisms and timing of death for non-statin users compared with early statin users during hospitalizations for AMI.

Patients who received early statin therapy had lower in-hospital mortality than those who did not receive early therapy (2.7% vs 9.2%, P=.001), and were less likely to die while in the hospital (OR=0.28; 95% CI, 0.12–0.63; P=.002). There was a favorable trend toward a reduction in mortality in early statin therapy-treated patients who underwent in-hospital PCI. For those patients who underwent fibrinolytic therapy, the benefit was less pronounced. A reduced risk of CHF development in early statin users (10.2% vs 25.7%, P<.001) was noted, as was an association between reduced peak CK and CK-MB values in early statin users compared with non-early statin users (624 ng/mL and 46 ng/mL, respectively, vs 848 ng/mL and 84 ng/mL, respectively, P<.001).

Early statin users were discharged from the hospital sooner than non-early statin users with a median of 96 hours from admission to discharge compared with a median of 120 hours (P<.001). Of patients who died in-hospital, early statin users died later, with a median time of admission to death of 132 hours versus 72 hours for non-early statin users (P=.3).

There was no toxicity associated with early, aggressive statin therapy such as myalgia, rhabdomyolysis, other muscle toxicity, or hepatotoxicity.

SOURCE Wright RS, Bybee KA, Miller WL, et al. Reduced risks of death and CHF are associated with statin therapy administered acutely within the first 24 h of AMI. Int J Cardiol. 2006;108:314–319.