Association between Statin Use as Primary Prevention and Outcomes in Acute Coronary Syndrome Patients during 2016 in Cengkareng General Hospital, Jakarta

Author : A. Priyana, A. F. Sunjaya, A. P. Sunjaya
Upload Date : 19-04-2018

Background: Cardiovascular disease, mainly Acute Coronary Syndrome (ACS), is the leading cause of death in the world today, including Indonesia. ACS often leads to increasing risk of numerous life threatening complications, such as malignant arrhythmia, pulmonary edema, and cardiogenic shock. Statin, the drug of choice for dyslipidemia, is widely used as a primary prevention for coronary artery disease. Moreover, it is essential in reducing mortality in ACS patients, either due to its LDL lowering or pleiotropic effects. Giving statin as primary prevention, therefore, may not only benefit in preventing ACS incidence, but also contribute towards lowering the incidence of complications in ACS patients.

Methods: A retrospective non-randomized study was conducted in 2016 involving 145 ACS patients at Cengkareng General Hospital. History of statin use was recorded, as well as ACS complications such as cardiogenic shock, malignant arrhythmia, pulmonary edema, and death. GRACE score was also compared between ACS patients who had received statin regularly with those who had not receive statin.

Results: Only 10.3% of ACS patients were found to receive statin for primary prevention. LDL values did not significantly differ between both groups. No significant differences in the incidence of complications were found between patients who received statin and those who didn’t. Compared to non-statin group, patients in the statin group showed lower proportion of cardiogenic shock, pulmonary edema, and mortality. GRACE score was found to be lower in the statin group, although not statistically significant.

Conclusion: This study showed that statin use for primary prevention was still very low among patients in West Jakarta. On the other hand, statin use in those patients might give potential benefits in preventing ACS complications and death. Larger and further comprehensive prospective studies are needed to evaluate the risks and benefits of statin as primary prevention of ACS.

KEYWORDS : statin, acute coronary syndrome, complications, death

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