Early, intensive statin treatment reduces 'hard' cardiovascular outcomes after acute coronary syndrome

European Journal of Preventive Cardiology
Gregory G SchwartzAnders G Olsson

Abstract

Background Early, intensive statin treatment is the standard of care after acute coronary syndrome (ACS). However, the benefit of this approach to prevent major adverse cardiovascular events has been demonstrated in only one randomised, placebo controlled trial. The Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) trial demonstrated that atorvastatin 80 mg daily, compared with placebo, reduced time to first occurrence of death, non-fatal myocardial infarction, resuscitated cardiac arrest, or hospitalisation for unstable angina (stroke not included) during the 16 week period following ACS. However, there were no significant effects on individual components of the composite endpoint except unstable angina. This led some to question whether early, intensive statin treatment reduces 'hard' events after ACS. Aim The burden of coronary heart disease after ACS, and therefore the efficacy of its treatment, depends not only on the occurrence of one ischaemic event, but rather on cumulative events experienced by patients. Accordingly, we conducted a post-hoc analysis of the MIRACL trial to examine the effect of atorvastatin on first as well as recurrent (i.e. total) hard cardiovascular events after ACS (death, ...Continue Reading

References

Dec 2, 1999·JAMA : the Journal of the American Medical Association·C R KumanaI J Lauder
Apr 13, 2001·JAMA : the Journal of the American Medical Association·G G SchwartzUNKNOWN Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) Study Investigators
Nov 19, 2013·Journal of the American College of Cardiology·Neil J StoneUNKNOWN American College of Cardiology/American Heart Association Task Force on Practice Guidelines

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Citations

Jul 18, 2017·European Journal of Preventive Cardiology·Massimo F Piepoli
Jun 23, 2020·Journal of Enzyme Inhibition and Medicinal Chemistry·Onur ArganNahit Gencer
Sep 11, 2019·European Heart Journal·François MachUNKNOWN ESC Scientific Document Group
Oct 9, 2019·Expert Opinion on Biological Therapy·Daniel SteffensUrsula Rauch-Kröhnert
Mar 21, 2020·Journal of the American College of Cardiology·Michael SzarekUNKNOWN SPARCL Committees and Investigators
Oct 31, 2020·Blood Coagulation & Fibrinolysis : an International Journal in Haemostasis and Thrombosis·Tomáš BolekMarián Mokáň
Oct 9, 2019·Atherosclerosis·UNKNOWN Authors/Task Force MembersUNKNOWN ESC National Cardiac Societies
May 14, 2020·Current Opinion in Cardiology·Christopher N Floyd, Anthony S Wierzbicki
May 14, 2021·Pharmacology Research & Perspectives·Ingrid ŠkorňováMarián Mokáň

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