Effect of lipid-lowering therapy on early mortality after acute coronary syndromes: an observational study.

Published

Journal Article

BACKGROUND: Lipid-lowering agents are known to reduce long-term mortality in patients with stable coronary disease or significant risk factors. However, the effect of lipid-lowering therapy on short-term mortality immediately after an acute coronary syndrome has not been determined. We did an observational study using data from two randomised trials to investigate this issue. METHODS: We used data from the GUSTO IIb and PURSUIT trials to compare all-cause mortality among patients with acute coronary syndromes who were discharged on lipid-lowering agents (n=3653) with those who were not (n=17,156). A propensity analysis was done to adjust for presumed selection biases in the prescription of lipid-lowering agents. FINDINGS: Lipid-lowering therapy was associated with a smaller proportion of deaths at 30 days (17 [0.5%] vs 179 [1.0%], hazard ratio 0.44 [95% CI 0.27-0.73], p=0.001) and at 6 months (63 [1.7%] vs 605 [3.5%], 0.48 [0.37-0.63], p<0.0001). After adjustment for the propensity to be prescribed lipid-lowering agents and other potential confounders, prescription of a lipid-lowering agent at discharge remained associated with a reduced risk of death at 6 months (0.67 [0.48-0.95], p=0.023). INTERPRETATION: Prescription of a lipid-lowering drug at hospital discharge was independently associated with reduced short-term mortality among patients after an acute coronary syndrome.

Full Text

Duke Authors

Cited Authors

  • Aronow, HD; Topol, EJ; Roe, MT; Houghtaling, PL; Wolski, KE; Lincoff, AM; Harrington, RA; Califf, RM; Ohman, EM; Kleiman, NS; Keltai, M; Wilcox, RG; Vahanian, A; Armstrong, PW; Lauer, MS

Published Date

  • April 2001

Published In

Volume / Issue

  • 357 / 9262

Start / End Page

  • 1063 - 1068

PubMed ID

  • 11297956

Pubmed Central ID

  • 11297956

Electronic International Standard Serial Number (EISSN)

  • 1474-547X

International Standard Serial Number (ISSN)

  • 0140-6736

Digital Object Identifier (DOI)

  • 10.1016/s0140-6736(00)04257-4

Language

  • eng