Statin use associated with a 50% mortality reduction after percutaneous coronary intervention

In patients undergoing percutaneous coronary intervention, the use of statins is associated with reduced mortality during pro­longed follow-up, a study has concluded. In the investigation, conducted in The Netherlands, patients using atorvastatin had a 23% lower mortality than those using simvastatin. The results of the study have been published in the April 2012 issue of Eurointervention.

In the study (EuroIntervention 2012;7:1420-1427), a team led by Ron T van Domburg and Jannet A Eindhoven from Department of Cardiology, Thoraxcenter, Erasmus Medical Center, Rotterdam, The Netherlands, aimed to investigate the association between different types of statins, in particular simvastatin and atorvastatin, and long-term mortality after percutaneous coronary intervention.

Between 2000 and 2005, a prospective cohort was constituted of 5,647 patients who underwent percutaneous coronary intervention. Type and doses of statin use were collected after the percutaneous coronary intervention procedure. Survival status was obtained from municipal civil registries. The primary endpoint was all-cause mortality. Secondary endpoints were cardiac and cancer mortality.

The median follow-up was five years (range three to nine years). During fol­low-up, 738 patients (13.1%) died. In total, 4,970 patients (88%) were on statin therapy four weeks after percutaneous coronary intervention of whom the majority used either atorvastatin (34%) or simvastatin (29%).

Cumulative survival rates at eight years in the atorvastatin group were 83%, and 79% in the simvastatin group (log-rank, p=0.004). After adjust­ment, statin use was associated with a 50% mortality reduction (HR 0.49, 95%CI 0.40-0.59) and atorvastatin use was associated with lower total mortality than simvastatin use (adjusted HR 0.77, 95% CI 0.61-0.97). This was largely driven by cancer mortality (adjusted HR 0.59, 95%CI 0.38-0.91).

Other investigators include Yoshinobu Onuma, Rohit M Oemrawsingh, Joost Daemen, Josephine W I van Nierop, Peter P T de Jaegere, Eric Boersma, Patrick W. Serruys, and Ron T van Domburg.