Beneficial Effects of Statin Therapy on Survival in Hypertensive Patients With Acute Myocardial Infarction: Data From the RICO Survey

Randomized studies have shown a reduction in cardiovascular events associated with low doses of statin among hypertensive patients at only moderate cardiovascular risk. The hypothesis of the present study was that statin therapy initiated during hospitalization could improve the long-term outcome af...

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Bibliographic Details
Published in:American journal of hypertension 2007-11, Vol.20 (11), p.1133-1139
Main Authors: Sicard, Pierre, Zeller, Marianne, Dentan, Gilles, Laurent, Yves, Touzery, Claude, L’huillier, Isabelle, Janin-Manificat, Luc, Lorgis, Luc, Beer, Jean-Claude, Makki, Hamib, Rochette, Luc, Cottin, Yves
Format: Article
Language:English
Subjects:
Acute Disease
acute myocardial infarction
Aged
Aged, 80 and over
Antihypertensive agents
Arterial hypertension. Arterial hypotension
Biological and medical sciences
Blood and lymphatic vessels
C-Reactive Protein - metabolism
Cardiology. Vascular system
Cardiovascular system
Clinical manifestations. Epidemiology. Investigative techniques. Etiology
cohort study
Data Collection
Databases, Factual
Female
France - epidemiology
Hospitalization
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use
Hypertension
Hypertension - complications
Lipids - blood
Logistic Models
Male
Medical sciences
Middle Aged
Myocardial Infarction - complications
Myocardial Infarction - mortality
Odds Ratio
Pharmacology. Drug treatments
Risk Factors
Secondary Prevention
statin
Treatment Outcome
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Summary:Randomized studies have shown a reduction in cardiovascular events associated with low doses of statin among hypertensive patients at only moderate cardiovascular risk. The hypothesis of the present study was that statin therapy initiated during hospitalization could improve the long-term outcome after acute myocardial infarction (MI) in hypertensive patients. From the French regional obserRvatoire des Infarctus de Côte d’Or (RICO) survey, 1076 patients with a history of hypertension, surviving acute MI were included. Patients on statin therapy initiated before their hospitalization were excluded from the study. Patients were categorized into two groups based on whether or not statin treatment was initiated during the hospital stay. Patients in the statin group were younger (70 years [range, 58 to 77 years] v 75 years [range, 65 to 82 years], P < .001) and were more likely to have hypercholesterolemia (42% v 28 %, P < .001). No differences were observed between the two groups for LDL-cholesterol levels on admission. At 1-year follow-up, cardiovascular mortality and rehospitalization for heart failure were lower in the statin group (respectively, 5% v 15%, P < .001; 5% v 7%, P < .001). Multivariate analysis showed that statin therapy was associated with decreased mortality (hazard ratio [95% confidence interval; CI]: 0.58 [0.32–0.98], P = .035) independently of either hypercholesterolemia, the use of β-blockers, angiotensin-converting enzyme inhibitors, or diuretics, but not with a decreased incidence of heart failure (hazard ratio [95% CI]: 0.88 [0.55–1.23], P = .152). In this observational study, the long-term benefits of statin therapy initiated in-hospital in hypertensive patients after acute MI was demonstrated. These findings may have implications for treatment optimization of hypertensive patients in secondary prevention.
ISSN:0895-7061
1879-1905
1941-7225
DOI:10.1016/j.amjhyper.2007.05.006