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dc.contributor.authorVedre, Ameeth
dc.contributor.authorGurm, Hitinder S.
dc.contributor.authorFroehlich, James B.
dc.contributor.authorKline-Rogers, Eva M.
dc.contributor.authorMontalescot, Gilles
dc.contributor.authorGore, Joel M.
dc.contributor.authorBrieger, David
dc.contributor.authorQuill, Ann L.
dc.contributor.authorEagle, Kim A.
dc.date2022-08-11T08:08:08.000
dc.date.accessioned2022-08-23T15:43:58Z
dc.date.available2022-08-23T15:43:58Z
dc.date.issued2009-12-08
dc.date.submitted2011-09-23
dc.identifier.citationAm J Cardiol. 2009 Dec 15;104(12):1613-7. <a href="http://dx.doi.org/10.1016/j.amjcard.2009.07.045">Link to article on publisher's site</a>
dc.identifier.issn0002-9149 (Linking)
dc.identifier.doi10.1016/j.amjcard.2009.07.045
dc.identifier.pmid19962463
dc.identifier.urihttp://hdl.handle.net/20.500.14038/27213
dc.description.abstractAnimal models of myocardial ischemia have demonstrated reduction in arrhythmias using statins. It was hypothesized that previous statin therapy before hospitalization might be associated with reductions of in-hospital arrhythmic events in patients with acute coronary syndromes. In this multinational, prospective, observational study (the Global Registry of Acute Coronary Events [GRACE]), data from 64,679 patients hospitalized for suspected acute coronary syndromes (from 1999 to 2007) were analyzed. The primary outcome of interest was in-hospital arrhythmic events in previous statin users compared with nonusers. The 2 primary end points were atrial fibrillation and the composite end point of ventricular tachycardia, ventricular fibrillation, and/or cardiac arrest. In-hospital death was also examined. Of the 64,679 patients, 17,636 (27%) had received previous statin therapy. Those taking statins had higher crude rates of histories of angina (69% vs 46%), diabetes (34% vs 22%), heart failure (15% vs 8.4%), hypertension (74% vs 58%), atrial fibrillation (9.3% vs 7.0%), and dyslipidemia (85% vs 35%). Patients previously taking statins were less likely to have in-hospital arrhythmias. In propensity-adjusted multivariable models, previous statin use was associated with a lower risk for ventricular tachycardia, ventricular fibrillation, or cardiac arrest (odds ratio 0.81, 95% confidence interval 0.72 to 0.96, p = 0.002); atrial fibrillation (odds ratio 0.81, 95% confidence interval 0.73 to 0.89, p <0.0001); and death (odds ratio 0.82, 95% confidence interval 0.70 to 0.95, p = 0.010). In conclusion, patients previously taking statins had a lower incidence of in-hospital arrhythmic events after acute coronary syndrome than those not previously taking statins. Our study suggests another possible benefit from appropriate primary and secondary prevention therapy with statins.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=19962463&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1016/j.amjcard.2009.07.045
dc.subjectAcute Coronary Syndrome
dc.subjectAged
dc.subjectArrhythmias, Cardiac
dc.subjectFemale
dc.subjectHumans
dc.subjectHydroxymethylglutaryl-CoA Reductase Inhibitors
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectPrimary Prevention
dc.subjectRisk Factors
dc.subjectTreatment Outcome
dc.subjectHealth Services Research
dc.titleImpact of prior statin therapy on arrhythmic events in patients with acute coronary syndromes (from the Global Registry of Acute Coronary Events [GRACE])
dc.typeJournal Article
dc.source.journaltitleThe American journal of cardiology
dc.source.volume104
dc.source.issue12
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/cor_grace/30
dc.identifier.contextkey2254949
html.description.abstract<p>Animal models of myocardial ischemia have demonstrated reduction in arrhythmias using statins. It was hypothesized that previous statin therapy before hospitalization might be associated with reductions of in-hospital arrhythmic events in patients with acute coronary syndromes. In this multinational, prospective, observational study (the Global Registry of Acute Coronary Events [GRACE]), data from 64,679 patients hospitalized for suspected acute coronary syndromes (from 1999 to 2007) were analyzed. The primary outcome of interest was in-hospital arrhythmic events in previous statin users compared with nonusers. The 2 primary end points were atrial fibrillation and the composite end point of ventricular tachycardia, ventricular fibrillation, and/or cardiac arrest. In-hospital death was also examined. Of the 64,679 patients, 17,636 (27%) had received previous statin therapy. Those taking statins had higher crude rates of histories of angina (69% vs 46%), diabetes (34% vs 22%), heart failure (15% vs 8.4%), hypertension (74% vs 58%), atrial fibrillation (9.3% vs 7.0%), and dyslipidemia (85% vs 35%). Patients previously taking statins were less likely to have in-hospital arrhythmias. In propensity-adjusted multivariable models, previous statin use was associated with a lower risk for ventricular tachycardia, ventricular fibrillation, or cardiac arrest (odds ratio 0.81, 95% confidence interval 0.72 to 0.96, p = 0.002); atrial fibrillation (odds ratio 0.81, 95% confidence interval 0.73 to 0.89, p <0.0001); and death (odds ratio 0.82, 95% confidence interval 0.70 to 0.95, p = 0.010). In conclusion, patients previously taking statins had a lower incidence of in-hospital arrhythmic events after acute coronary syndrome than those not previously taking statins. Our study suggests another possible benefit from appropriate primary and secondary prevention therapy with statins.</p>
dc.identifier.submissionpathcor_grace/30
dc.contributor.departmentDepartment of Medicine, Division of Cardiovascular Medicine
dc.contributor.departmentDepartment of Surgery
dc.contributor.departmentCenter for Outcomes Research
dc.source.pages1613-7


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