Statin use before acute coronary syndrome and coronary risk factors, clinical presentation, interventions, and outcomes: ACC-NCDR-CathPCI Registry in India

Statins are used for coronary artery disease (CAD) primary and secondary prevention. Since there are very few studies on the association of statin use before acute coronary syndrome (ACS) with clinical presentation and outcomes are available. Rajeev Gupta presented a session held at the European Society of Cardiology (ESC) Congress from 30th August to 2nd September 2024, in London.

The study was compared with statin-user and statin-naïve ACS patients for clinical and angiographic findings and in-hospital and 3-year outcomes following percutaneous coronary intervention (PCI). 8,296 ACS patients were included who underwent PCI from September 2017 to December 2023 in the ACC-NCDR-CathPCI registry in India. Of these, 3,149 (38%) were on statins before their ACS event, and 5,147 (62%) were statin-naïve. Statin users were older and had higher rates of hypertension, diabetes, and pre-existing CAD, with lower cholesterol levels.

Experienced fewer STEMIs, better LVEF, and shorter hospital stays. In-hospital mortality rates were lower for statin users compared to non-users. Follow-up data for 3,813 patients showed that statin users had a lower incidence of major cardiovascular events (6.9% vs. 8.9%) and cardiovascular deaths (3.2% vs. 4.7%). Differences in outcomes were less pronounced after adjusting for baseline characteristics and interventions.

Acute coronary syndrome patients taking pre-admission statins have significantly lower in-hospital and long-term cardiovascular and all-cause mortality following PCI.