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  • Title: Prognostic interactions between statins and in-hospital revascularisation on the outcome of acute coronary syndrome.
    Author: Wong CK, Tang EW, Herbison P.
    Journal: Heart Lung Circ; 2009 Aug; 18(4):262-5. PubMed ID: 19167924.
    Abstract:
    AIM: To examine if the prognostic benefit of in-hospital revascularisation on survival among patients with acute coronary syndrome (ACS) was influenced by the use of statins at the initial hospital discharge. METHODS: All ACS survivors discharged from Dunedin and Invercargill coronary care units between the years 2000 and 2002 were included. RESULTS: Of the 1057 hospital survivors with ACS (age 64.9+/-12.6 years, 63% male), 481 (45.5%) had in-hospital revascularisation (CABG in 123 patients and PCI in 377, including 19 with both procedures). Statins were prescribed at discharge in 47% of patients without and 73% of patients with revascularisation. Revascularisation was associated with lower mortality up to 5 years of follow-up (hazard ratio 0.29, 95% confidence interval 0.20-0.42). After adjusting for baseline differences and the use of statins, the hazard ratio was 0.39 (95% confidence interval 0.27-0.58). While the use of statins was a predictor for long-term survival (p<0.001), no significant interaction was found between the use of statins and in-hospital revascularisation in predicting survival. CONCLUSION: Both in-hospital revascularisation and the use of statins at hospital discharge independently improved outcome over a follow-up period of 2-5 years. There was no prognostic interaction detected between these two beneficial therapies.
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