Prehospital Statin Therapy and Outcomes in ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention.

Whether prehospital statin therapy is associated with better outcomes in patients with ST-elevation myocardial infarction (STEMI) undergoing primary percutaneous coronary intervention (PCI) remains unclear. We evaluated the association between previous statin use and lower 1-year cardiovascular event rates in this population. We analyzed data from 827 consecutive patients with STEMI undergoing primary PCI from a multicenter registry and classified them into a prior statin group (n = 510, 62%) and a nonprior statin group (n = 317, 38%). The primary endpoint was 1-year major adverse cardiovascular events (MACE), defined as cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke. Inverse probability of treatment weighting (IPTW) was the primary analytic approach. After IPTW adjustment, the prior statin group had a lower weighted 1-year MACE incidence than the nonprior statin group (3.1% vs 7.6%; hazard ratio, 0.31; 95% confidence interval, 0.17 to 0.57). The association between previous statin therapy and lower MACE risk was consistent in multivariable Cox regression and sensitivity analyses using modified IPTW approaches. In conclusion, statin therapy before STEMI onset was associated with lower 1-year cardiovascular event rates after primary PCI, a finding mainly driven by lower mortality.