Hydrophilic vs. Lipophilic Statins in Diabetic Patients　- Comparison of Long-Term Outcomes After Acute Myocardial Infarction.

Abstract

Background: Studies comparing the cardiac consequences of hydrophilic and lipophilic statins in experimental and clinical practice settings have produced inconsistent results. In particular, evidence focusing on diabetic patients after acute myocardial infarction (AMI) is lacking. Methods and Results: From the Osaka Acute Coronary Insufficiency Study (OACIS) registry database, 1,752 diabetic patients with AMI who were discharged with a prescription for statins were studied. Long-term outcomes were compared between hydrophilic and lipophilic statins, including all-cause death, recurrent myocardial infarction (re-MI) and admission for heart failure (HF) and a composite of these (major adverse cardiac events; MACE). During a median follow-up period of 1,059 days, all-cause death, non-fatal re-MI, admission for HF, and MACE occurred in 95, 89, 112 and 249 patients, respectively. Although there was no significant difference between statins in the risk of all-cause death, re-MI and MACE, the risk of HF admission was significantly lower in patients with hydrophilic than lipophilic statins before (adjusted hazard ratio [aHR], 0.560; 95% CI: 0.345-0.911, P=0.019) and after (aHR, 0.584; 95% CI: 0.389-0.876, P=0.009) propensity score matching. Hydrophilic statin use was consistently associated with lower risk for HF admission than lipophilic statins across the subgroup categories. Conclusions: In the present diabetic patients with AMI, hydrophilic statins were associated with a lower risk of admission for HF than lipophilic statins.

• Authors: Ryu Shutta, Daisaku Nakatani, Yasuhiko Sakata, Shungo Hikoso, Hiroya Mizuno, Shinichiro Suna, Tetsuhisa Kitamura, Katsuki Okada, Tomoharu Dohi, Takayuki Kojima, Bolrathanak Oeun, Akihiro Sunaga, Hirota Kida, Hiroshi Sato, Masatsugu Hori, Issei Komuro, Masami Nishino, Yasushi Sakata, Osaka Acute Coronary Insufficiency Study (OACIS) Investigators
• Journal: Circulation reports (Circ Rep) Vol. 2 Issue 5 Pg. 280-287 (Mar 20 2020) ISSN: 2434-0790 [Electronic] Japan
• PMID: 33693242 (Publication Type: Journal Article)
• Copyright: Copyright © 2020, THE JAPANESE CIRCULATION SOCIETY.