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Relation between previous lipid-lowering therapy and infarct size (creatine kinase-MB level) in patients presenting with acute myocardial infarction.

Publication ,  Journal Article
Aronow, HD; Lincoff, AM; Quinn, MJ; McRae, AT; Gurm, HS; Houghtaling, PL; Granger, CB; Harrington, RA; Van de Werf, F; Topol, EJ; Lauer, MS ...
Published in: Am J Cardiol
November 1, 2008

Animal experimental data have shown that lipid-lowering agents reduce myocardial infarct size. This association has not been well studied in humans. We compared infarct size in 10,548 patients in the GUSTO IIb and PURSUIT trials who were (n = 1,028) or were not (n = 9,520) on lipid-lowering therapy before an enrolling myocardial infarction (MI). Patients using lipid-lowering agents before their index MI had smaller infarcts than those who were not using these agents (median peak creatine kinase [CK]-MB 4.2 vs 5.2 times the upper limit of normal [ULN]; p <0.0001). Similarly, in an unadjusted model, patients on previous lipid-lowering therapy were less likely to have a peak CK-MB >3 times the ULN (620 of 1,028 [60.3%] vs 6,486 of 9,520 patients [68.1%]; p <0.001; relative risk 0.88, 95% confidence interval 0.84 to 0.93, p <0.0001). In a covariate- and propensity-adjusted multivariable model, the association between pretreatment with lipid-lowering agents and smaller infarct size persisted (relative risk for CK-MB >3 times the ULN 0.94, 95% confidence interval 0.88 to 0.99, p = 0.04). In conclusion, patients on lipid-lowering agents before an MI had significantly smaller infarcts. These findings suggest that lipid-lowering therapy may exert additional salutary effects in the setting of acute coronary syndromes.

Duke Scholars

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

November 1, 2008

Volume

102

Issue

9

Start / End Page

1119 / 1124

Location

United States

Related Subject Headings

  • Risk Factors
  • Necrosis
  • Myocytes, Cardiac
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Hypolipidemic Agents
  • Hyperlipidemias
  • Humans
  • Female
 

Citation

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Aronow, H. D., Lincoff, A. M., Quinn, M. J., McRae, A. T., Gurm, H. S., Houghtaling, P. L., … GUSTO IIb and PURSUIT Trial Investigators, . (2008). Relation between previous lipid-lowering therapy and infarct size (creatine kinase-MB level) in patients presenting with acute myocardial infarction. Am J Cardiol, 102(9), 1119–1124. https://doi.org/10.1016/j.amjcard.2008.06.032
Aronow, Herbert D., A Michael Lincoff, Martin J. Quinn, A Thomas McRae, Hitinder S. Gurm, Penny L. Houghtaling, Christopher B. Granger, et al. “Relation between previous lipid-lowering therapy and infarct size (creatine kinase-MB level) in patients presenting with acute myocardial infarction.Am J Cardiol 102, no. 9 (November 1, 2008): 1119–24. https://doi.org/10.1016/j.amjcard.2008.06.032.
Aronow HD, Lincoff AM, Quinn MJ, McRae AT, Gurm HS, Houghtaling PL, et al. Relation between previous lipid-lowering therapy and infarct size (creatine kinase-MB level) in patients presenting with acute myocardial infarction. Am J Cardiol. 2008 Nov 1;102(9):1119–24.
Aronow, Herbert D., et al. “Relation between previous lipid-lowering therapy and infarct size (creatine kinase-MB level) in patients presenting with acute myocardial infarction.Am J Cardiol, vol. 102, no. 9, Nov. 2008, pp. 1119–24. Pubmed, doi:10.1016/j.amjcard.2008.06.032.
Aronow HD, Lincoff AM, Quinn MJ, McRae AT, Gurm HS, Houghtaling PL, Granger CB, Harrington RA, Van de Werf F, Topol EJ, Lauer MS, GUSTO IIb and PURSUIT Trial Investigators. Relation between previous lipid-lowering therapy and infarct size (creatine kinase-MB level) in patients presenting with acute myocardial infarction. Am J Cardiol. 2008 Nov 1;102(9):1119–1124.
Journal cover image

Published In

Am J Cardiol

DOI

EISSN

1879-1913

Publication Date

November 1, 2008

Volume

102

Issue

9

Start / End Page

1119 / 1124

Location

United States

Related Subject Headings

  • Risk Factors
  • Necrosis
  • Myocytes, Cardiac
  • Myocardial Infarction
  • Middle Aged
  • Male
  • Hypolipidemic Agents
  • Hyperlipidemias
  • Humans
  • Female