Association between statin use and the prognosis of patients with acute myocardial infarction complicated with diabetes

Xuehao Lu; Luming Zhang; Shaojin Li; Dan He; Tao Huang; Hongsheng Lin; Haiyan Yin; Jun Lyu

doi:10.3389/fcvm.2022.976656

Association between statin use and the prognosis of patients with acute myocardial infarction complicated with diabetes

Front Cardiovasc Med. 2022 Aug 8:9:976656. doi: 10.3389/fcvm.2022.976656. eCollection 2022.

Authors

Xuehao Lu¹, Luming Zhang¹, Shaojin Li², Dan He^{1

3}, Tao Huang⁴, Hongsheng Lin², Haiyan Yin¹, Jun Lyu^{4

5}

Affiliations

¹ Department of Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, China.
² Department of Orthopaedics, The First Affiliated Hospital of Jinan University, Guangzhou, China.
³ Department of Anesthesiology, Women's and Children's Hospital of Hengyang, Hengyang, China.
⁴ Department of Clinical Research, The First Affiliated Hospital of Jinan University, Guangzhou, China.
⁵ Guangdong Provincial Key Laboratory of Traditional Chinese Medicine Informatization, Guangzhou, China.

Abstract

Background: Type 2 diabetes leads to an increase in the prevalence of lipid abnormalities, which increases the risk of cardiovascular disease. Therefore, current guidelines generally recommend the use of moderate or high-intensity statins in patients with type 2 diabetes. There are still few studies on the overall risk benefit balance of statins for acute myocardial infarction (AMI) patients with diabetes. Compared with other types of lipid-lowering drugs, the advantage of statins for the prognosis of patients with AMI has not yet been determined. We investigated the effects of statins and non-statins on intensive care unit (ICU) and inpatient mortality in patients with AMI and diabetes.

Methods: This study retrospectively collected all patients with AMI and diabetes in the Medical Information Mart Intensive Care-IV database. We assessed ICU and in-hospital mortality rates during hospitalization in both groups. The clinical end point was in-hospital mortality and ICU mortality. Kaplan-Meier and Cox proportional-hazards regression models were applied to analyze the correlation between the two groups and the outcomes.

Results: Data on 1,315 patients with AMI and diabetes were collected, among which 1,211 used statins during hospitalization. The overall in-hospital mortality of patients with AMI and diabetes was 17.2%, and the total ICU mortality was 12.6%. The in-hospital mortality was lower for the statin group than for the non-statin group (13.9% and 55.8%, respectively). Kaplan-Meier survival curves demonstrated that survival probability was higher in the statin group than in the non-statin group. In the cohort without hyperlipidemia, the statin group had lower risks of ICU death (HR = 0.12, 95% CI = 0.04-0.40) and in-hospital death (HR = 0.36, 95% CI = 0.16-0.84) compared with the non-statin group.

Conclusions: Statins can significantly reduce ICU and in-hospital mortality rates in patients with AMI and diabetes. Even in the population without hyperlipidemia, statins can still reduce the mortality in patients with AMI and diabetes.

Keywords: acute myocardial infarction; cardiovascular disease; diabetes; lipid-lowering drugs; statin.