Statin pretreatment and presentation patterns in patients with acute coronary syndromes

Statin therapy stabilizes coronary plaque, and it could be associated with less ST elevation myocardial infarction (STEMI) and acute myocardial infarction (AMI) [which includes, STEMI + non-STEMI (NSTEMI)], among patients presenting acute coronary syndromes (ACS). The aim of this study was to determine any association between prior use of statins and presentation patterns in 1,322 ACS patients admitted between 2014 and 2016: STEMI [247], NSTEMI [461] or unstable angina (UA) [614]. Coronary risk factors, history and chronic use of statins, aspirin and beta blockers were collected. Uni, multivariable and propensity score analysis were performed. About half (46%) of the patients received statins but only 14% high doses. UA patients received more statins and higher doses =335 (54%)/117 (19%) compared to NSTEMI =189 (40%)/49 (11%), and STEMI =77 (31%)/21 (9%), P<0.0001. Statin use was independently associated with a lower probability of STEMI [vs. NSTEMI/UA, odds ratio (OR) =0.70, 95% CI: 0.50–0.97, P=0.03] or AMI (vs. UA, OR=0.66, 95% CI: 0.51–0.84, P<0.01). Results were confirmed by propensity score analysis (OR=0.739, 95% CI: 0.588–0.922, P<0.01). Pretreatment with statins in ACSs was more associated with UA than with myocardial infarction. This could be a way of coronary atherosclerotic plaque’s stabilization.