Researchers at UCLA ( University of California- Los Angeles ) found that early treatment with a statin, a cholesterol lowering drug, within 24 hours of having a heart attack reduced in-hospital mortality rates by over 50 percent.

Experimental models of ischemia and reperfusion have shown that statins have early cardioprotective effects.
However, the effect of statin use within the first 24 hours of admission on early morbidity and mortality in acute myocardial infarction ( AMI ) has not been well studied.

The study is published in the American Journal of Cardiology.

Data were collected on 300,823 patients who had AMI in the National Registry of Myocardial Infarction 4.

In-hospital events were compared between patients who continued statin therapy received before the index AMI hospitalization (n = 17,118) or newly started statin therapy within the first 24 hours of hospitalization (n = 21,978) and patients who did not receive early statin treatment (n = 126,128) or whose statin therapy was discontinued (n = 9,411).

New or continued treatment with a statin in the first 24 hours was associated with a decreased risk of mortality compared with no statin use ( 4.0% and 5.3% compared with 15.4% no statin ).
Discontinuation of statin treatment was associated with a slightly increased risk of mortality (16.5%).

Early statin use was also associated with a lower incidence of cardiogenic shock, arrhythmias, cardiac arrest, rupture, but not recurrent myocardial infarction.

Researchers found that patients who had received statin therapy before hospitalization and within 24 hours following a heart attack had a 54 percent lower risk of in-hospital mortality compared to patients not on statin therapy.

Patients who had not received previous statin therapy, but who were newly started on the medication within 24 hours of hospitalization had a 58 percent reduction in mortality compared to patients not on statin therapy.

In conclusion, the use of statin therapy within the first 24 hours of hospitalization for AMI is associated with a significantly lower rate of early complications and in-hospital mortality.

According to Gregg C. Fonarow, Ahmanson-UCLA Cardiomyopathy Center. statins work by increasing nitric oxide in the cardiovascular system, which offers a number of benefits including reducing inflammation that may help limit cell damage from a heart attack.

The next step is to develop a clinical trial to corroborate these strong observational findings.
Fonarow believes that early statin use within 24 hours of a heart attack may become a standard treatment. “As statins are already routinely started in myocardial infarction patients prior to hospital discharge, it would be relatively easy to administer this medication on arrival to the emergency department.”

Source: University of California- Los Angeles, 2005


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