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Evaluation of the impact of statin therapy on the obesity paradox in patients with acute myocardial infarction A propensity score matching analysis from the Korea Acute Myocardial Infarction Registry

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Author(s)
Ki-Bum WonSeung-Ho HurChang-Wook NamSoe Hee AnnGyung-Min ParkSang-Gon LeeHyo-Eun KimYun-Kyeong ChoHyuck-Jun YoonHyoung-Seob ParkHyungseop KimSeongwook HanMyung-Ho JeongYoung-Keun AhnSeung-Woon RhaChong-Jin KimMyeong-Chan ChoHyo-Soo KimShung-Chull ChaeKee-Sik KimYoung-Jo KimKwon-Bae KimPhilip Barterfor the KAMIR (Korea Acute Myocardial Infarction Registry) Investigators
Keimyung Author(s)
Hur, Seung HoNam, Chang WookKim, Hyung SeopCho, Yun KyeongPark, Hyoung SeobYoon, Hyuck JunHan, Seong WookKim, Kwon Bae
Department
Dept. of Internal Medicine (내과학)
Journal Title
Medicine
Issued Date
2017
Volume
96
Issue
35
Keyword
acute myocardial infarctionmortalityobesitystatins
Abstract
The phenomenon of obesity paradox after acute myocardial infarction (AMI) has been reported under strong recommendation of statin therapy. However, the impact of statin therapy on this paradox has not been investigated. This study investigated the impact of statin therapy on 1-year mortality according to obesity after AMI. A total of 2745 AMI patients were included from the Korea Acute Myocardial Infarction Registry after 1:4 propensity score matching analysis (n = 549 for nonstatin group and n = 2196 for statin group). Primary and secondary outcomes were all-cause and cardiac death, respectively. During 1-year follow-up, the incidence of all-cause (8.4% vs 3.7%) and cardiac (6.2% vs 2.3%) death was higher in nonstatin group than in statin (P < .001, respectively). In nonstatin group, the incidence of all-cause (7.2% vs 9.0%) and cardiac (5.5% vs 6.5%) death did not differ significantly between obese and nonobese patients. However, in statin group, obese patients had lower 1-year rate of all-cause (1.7% vs 4.8%) and cardiac (1.2% vs 2.9%) death (P < .05, respectively), and lower cumulative rates by Kaplan-Meier analysis of all-cause and cardiac death compared with nonobese patients (log-rank P < .05, respectively). The overall risk of all-cause death was significantly lower in obese than in nonobese patients only in statin group (hazard ratio: 0.35; P = .001). After adjusting for confounding factors, obesity was independently associated with decreased risk of all-cause death in statin group. In conclusion, the greater benefit of statin therapy for survival in obese patients is further confirmation of the obesity paradox after AMI.
Keimyung Author(s)(Kor)
허승호
남창욱
김형섭
조윤경
박형섭
윤혁준
한성욱
김권배
Publisher
School of Medicine (의과대학)
Citation
Ki-Bum Won et al. (2017). Evaluation of the impact of statin therapy on the obesity paradox in patients with acute myocardial infarction A propensity score matching analysis from the Korea Acute Myocardial Infarction Registry. Medicine, 96(35), e7180–e7180. doi: 10.1097/MD.0000000000007180
Type
Article
ISSN
0025-7974
DOI
10.1097/MD.0000000000007180
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/41249
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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