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Cited by 5Lipoproteins and Cardiovascular HealthAcute Myocardial Infarction ResearchCancer, Lipids, and Metabolism

Impact of the statin escape phenomenon on long-term clinical outcomes in patients with acute myocardial infarction: Subgroup analysis of the Nagoya Acute Myocardial Infarction Study (NAMIS)

Ota, Tomoyuki, Ishii, Hideki, Suzuki, Susumu, Shibata, Yohei, Tatami, Yosuke, Harata, Shingo, Shimbo, Yusaku, Takayama, Yohei +6 more·2015·Atherosclerosis
DOI 10.1016/j.atherosclerosis.2015.07.012
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Abstract

Background Statins are reportedly effective in the primary and secondary prevention of cardiovascular disease, mainly due to their ability to aggressively reduce low-density lipoprotein cholesterol (LDL-C) levels. However, patients sometimes exhibit the so-called "statin escape" phenomenon. The purpose of our study was to investigate the impact of the statin escape phenomenon on long-term clinical outcomes in patients with acute myocardial infarction (AMI).Method This was a subgroup analysis of 1144 patients from the Nagoya Acute Myocardial Infarction Study (NAMIS) treated between January 2004 and December 2012. We analyzed 660 patients who initiated statin treatment after AMI. Statin escape phenomenon was defined as an increase in the LDL-C levels during the 9-month treatment period by >10% of the initial values after 4 weeks of initiating statin treatment. Patients were divided into two groups depending on whether they exhibited the statin escape phenomenon, with 474 patients in the non-escape group and 186 patients in the escape group.Result Compared to the non-escape group, the escape group showed significantly lower LDL-C levels at 4 weeks after treatment initiation (81.3 ± 20.1 mg/dL vs. 101.1 ± 25.4 mg/dL, P < 0.01). By contrast, the escape group showed significantly higher LDL-C levels at 9 months after treatment initiation (105.8 ± 28.3 mg/dL vs. 90.3 ± 22.6 mg/dL, P < 0.01). Major adverse cardiac and cerebrovascular events (MACCE; a composite of all-cause death, MI, and stroke) were more frequent in the escape group than in the non-escape group (10.8% vs. 6.1%, P = 0.03). Multivariate analysis showed that statin escape phenomenon was an independent predictor of MACCE (hazard ratio: 2.02, 95% confidence interval: 1.11-3.66, P = 0.02).Conclusion Statin escape phenomenon may be an independent predictor of long-term clinical outcomes in AMI patients.

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  • The incidence of cardiovascular events was significantly decreased in patients whose LDL-C levels were controlled at < 100 mg/dL in a long-term Japanese observational study of secondary prevention.

    “In a long-term Japanese observational study of secondary prevention, the incidence of cardiovascular events was significantly decreased in patients whose LDL-C levels were controlled at < 100 mg/dL632).”

    From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [632]

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Authors
Ota, T., Ishii, H., Suzuki, S., Shibata, Y., Tatami, Y., Harata, S., Shimbo, Y., Takayama, Y., Tanaka, A., Kawamura, Y., Osugi, N., Maeda, K., Kondo, T., & Murohara, T.
Affiliations
Nagoya University (JP)
Corresponding author
Ota, Tomoyuki
ORCID
Venue
Atherosclerosis
Publisher
Elsevier BV
Published
2015-09
Volume
242
Issue
1
Pages
155-160
ISSN
0021-9150 (ISSN-L)
DOI
10.1016/j.atherosclerosis.2015.07.012
OpenAlex
W1811682990
Cited by
5
References
34
Citations by year
2025: 1 · 2023: 1 · 2019: 1 · 2018: 1 · 2017: 1
FWCI
0.67
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • Atherosclerosis (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Cancer, Lipids, and Metabolism
Keywords
statins, acute myocardial infarction, LDL cholesterol, major adverse cardiac and cerebrovascular events, long-term clinical outcomes, secondary prevention
MeSH terms
Aged, Female, Humans, Japan, Cholesterol, HDL, Cholesterol, LDL, Male, Middle Aged, Myocardial Infarction, Prospective Studies, Recurrence, Risk Factors, Time Factors, Biomarkers, Multivariate Analysis, Chi-Square Distribution, Proportional Hazards Models, Treatment Outcome, Disease-Free Survival, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Dyslipidemias, Kaplan-Meier Estimate, Secondary Prevention

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