Search: onr:"swepub:oai:DiVA.org:uu-506916" >
Statin Treatment In...
Statin Treatment Intensity, Discontinuation, and Long-Term Outcome in Patients With Acute Myocardial Infarction and Impaired Kidney Function
-
- Khedri, Masih (author)
- Karolinska Institutet,Danderyd Hospital
-
- Szummer, Karolina (author)
- Karolinska Institute
-
- Lundman, Pia (author)
- Karolinska Institutet,Danderyd Hospital
-
show more...
-
- Jernberg, Tomas (author)
- Karolinska Institutet,Danderyd Hospital
-
- Desta, Liyew (author)
- Karolinska Institute,Karolinska Institutet
-
- Lindahl, Bertil, 1957- (author)
- Uppsala University,Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)
-
- Erlinge, David (author)
- Lund University,Lunds universitet,Molekylär kardiologi,Forskargrupper vid Lunds universitet,Molecular Cardiology,Lund University Research Groups,Skåne University Hospital
-
- Jacobson, Stefan H. (author)
- Karolinska Institutet,Danderyd Hospital
-
- Spaak, Jonas (author)
- Karolinska Institutet,Danderyd Hospital
-
show less...
-
(creator_code:org_t)
- Wolters Kluwer, 2023
- 2023
- English.
-
In: Journal of Cardiovascular Pharmacology. - : Wolters Kluwer. - 0160-2446 .- 1533-4023. ; 81:6, s. 400-410
- Related links:
-
http://dx.doi.org/10...
-
show more...
-
https://urn.kb.se/re...
-
https://doi.org/10.1...
-
http://kipublication...
-
https://lup.lub.lu.s...
-
show less...
Abstract
Subject headings
Close
- Statin dosage in patients with acute myocardial infarction (AMI) and concomitant kidney dysfunction is a clinical dilemma. We studied discontinuation during the first year after an AMI and long-term outcome in patients receiving high versus low–moderate intensity statin treatment, in relation to kidney function. For the intention-to-treat analysis (ITT-A), we included all patients admitted to Swedish coronary care units for a first AMI between 2005 and 2016 that survived in-hospital, had known creatinine, and initiated statin therapy (N = 112,727). High intensity was initiated in 38.7% and low–moderate in 61.3%. In patients with estimated glomerular filtration rate (eGFR) < 60 mL/min/1.73 m2, 25% discontinued treatment the first year; however, the discontinuation rate was similar regardless of the statin intensity. After excluding patients who died, changed therapy, or were nonadherent during the first year, 84,705 remained for the on-treatment analysis (OT-A). Patients were followed for 12.6 (median 5.6) years. In patients with eGFR 30–59 mL/min, high-intensity statin was associated with lower risk for the composite death, reinfarction, or stroke both in ITT-A (hazard ratio [HR] 0.93; 95% confidence interval, 0.87–0.99) and OT-A (HR 0.90; 0.83–0.99); the interaction test for OT-A indicated no heterogeneity for the eGFR < 60 mL/min group (P = 0.46). Similar associations were seen for all-cause mortality. We confirm that high-intensity statin treatment is associated with improved long-term outcome after AMI in patients with reduced kidney function. Most patients with reduced kidney function initiated on high-intensity statins are persistent after 1 year and equally persistent as patients initiated on low–moderate intensity.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Urologi och njurmedicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Urology and Nephrology (hsv//eng)
Keyword
- acute myocardial infarction
- chronic kidney disease
- statin intensity
- mortality
- stroke
- reinfarction
- acute myocardial infarction
- chronic kidney disease
- mortality
- reinfarction
- statin intensity
- stroke
Publication and Content Type
- ref (subject category)
- art (subject category)
Find in a library
To the university's database
- By the author/editor
-
Khedri, Masih
-
Szummer, Karolin ...
-
Lundman, Pia
-
Jernberg, Tomas
-
Desta, Liyew
-
Lindahl, Bertil, ...
-
show more...
-
Erlinge, David
-
Jacobson, Stefan ...
-
Spaak, Jonas
-
show less...
- About the subject
-
- MEDICAL AND HEALTH SCIENCES
-
MEDICAL AND HEAL ...
-
and Clinical Medicin ...
-
and Cardiac and Card ...
-
- MEDICAL AND HEALTH SCIENCES
-
MEDICAL AND HEAL ...
-
and Clinical Medicin ...
-
and Urology and Neph ...
- Articles in the publication
-
Journal of Cardi ...
- By the university
-
Uppsala University
-
Karolinska Institutet
-
Lund University