Association of Pre-Admission Statin Therapy and the Inflammatory Response in ST Elevation Myocardial Infarction Patients

Zach Rozenbaum Cardiology, Sourasky Tel Aviv Medical Center, Israel Sackler School of Medicine, Tel Aviv University, Israel Dor Ravid Cardiology, Sourasky Tel Aviv Medical Center, Israel Sackler School of Medicine, Tel Aviv University, Israel Gilad Margolis Cardiology, Sourasky Tel Aviv Medical Center, Israel Sackler School of Medicine, Tel Aviv University, Israel Shafik Khoury Cardiology, Sourasky Tel Aviv Medical Center, Israel Sackler School of Medicine, Tel Aviv University, Israel Natalia Kaufman Cardiology, Sourasky Tel Aviv Medical Center, Israel Sackler School of Medicine, Tel Aviv University, Israel Gad Keren Cardiology, Sourasky Tel Aviv Medical Center, Israel Sackler School of Medicine, Tel Aviv University, Israel Assi Milwidsky Cardiology, Sourasky Tel Aviv Medical Center, Israel Sackler School of Medicine, Tel Aviv University, Israel Yacov Shacham Cardiology, Sourasky Tel Aviv Medical Center, Israel Sackler School of Medicine, Tel Aviv University, Israel

Purpose: To demonstrate the possible association of statin therapy with C reactive protein (CRP) serial measurements in ST elevation myocardial infarction (STEMI) patients.

Materials and methods: STEMI patients between 2008 and 2016 with available CRP data from admission were divided into two groups according to pre-admission statin therapy. A second CRP measurement was noted following primary coronary intervention (within 24 hours from admission). The difference between the two measurements was designated ΔCRP.

Results: The cohort consisted of 1134 patients with a median age of 61 (IQR 52-70), 81% males. Patients on statins prior to admission (298/1134, 26%) were more likely to have CRP levels within normal range (≤5 mg/l) compared to patients without prior treatment, both at admission (75% vs. 24. %, p=0.004) and at 24 hours (70% vs. 48%, p=0.029). The prevalence of patients with pre-admission statin therapy decreased as ΔCRP increased (p=0.004). The likelihood of ΔCRP to be above the normal range in patients with pre-admission statin therapy was reduced after age and gender adjustments (OR 0.54, 95% CI 0.32-0.92, p=0.023) and in multivariate (OR 0.57, 95% CI 0.33-0.99, p=0.048) analysis.

Conclusion: Pre-admission statin therapy is associated with lesser inflammatory response in STEMI patients, highlighting statins` pathophysiological importance.

Zach Rozenbaum

איכילוב