Withdrawal of statins increases event rates in patients with acute coronary syndromes

Circulation
Christopher HeeschenPlatelet Receptor Inhibition in Ischemic Syndrome Management (PRISM) Investigators

Abstract

HMG-CoA Reductase Inhibitors (statins) reduce cardiac event rates in patients with stable coronary heart disease. Withdrawal of chronic statin treatment during acute coronary syndromes may impair vascular function independent of lipid-lowering effects and thus increase cardiac event rate. We investigated the effects of statins on the cardiac event rate in 1616 patients of the Platelet Receptor Inhibition in Ischemic Syndrome Management (PRISM) study who had coronary artery disease and chest pain in the previous 24 hours. We recorded death and nonfatal myocardial infarction during the 30-day follow-up. Baseline clinical characteristics did not differ among 1249 patients without statin therapy, 379 patients with continued statin therapy, and 86 patients with discontinued statin therapy after hospitalization. Statin therapy was associated with a reduced event rate at 30-day follow-up compared with patients without statins (adjusted hazard ratio, 0.49 [95% CI, 0.21 to 0.86]; P=0.004). If the statin therapy was withdrawn after admission, cardiac risk increased compared with patients who continued to receive statins (2.93 [95% CI, 1.64 to 6.27]; P=0.005) and tended to be higher compared with patients who never received statins (1.69 ...Continue Reading

References

Oct 5, 1988·Journal of the National Cancer Institute·F E HarrellB G Pollock
Aug 18, 1994·The New England Journal of Medicine·G LiuzzoA Maseri
Oct 19, 1996·Lancet·C J VaughanB M Buckley
May 23, 1998·The New England Journal of Medicine·UNKNOWN Platelet Receptor Inhibition in Ischemic Syndrome Management (PRISM) Study Investigators
Jun 5, 1998·JAMA : the Journal of the American Medical Association·R S Rosenson, C C Tangney
Dec 5, 1998·The New England Journal of Medicine·UNKNOWN Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group
Jan 14, 1999·The New England Journal of Medicine·R Ross
Feb 6, 1999·Journal of the American College of Cardiology·W H KaesemeyerR W Caldwell
Feb 17, 1999·Journal of Molecular and Cellular Cardiology·P R Hansen
Mar 12, 1999·Journal of Molecular and Cellular Cardiology·I Fleming, R Busse
Jan 19, 2000·Circulation·D J MaronM F Linton
Feb 26, 2000·Cardiovascular Research·J Y JeremyA C Newby
Feb 26, 2000·Cardiovascular Research·M KibbeE Tzeng
Dec 2, 2000·Nature Medicine·B KwakF Mach
Apr 13, 2001·JAMA : the Journal of the American Medical Association·G G SchwartzUNKNOWN Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) Study Investigators

❮ Previous
Next ❯

Citations

Nov 3, 2006·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Nader N Boushra, Muhammad Muntazar
Jun 18, 2009·Internal and Emergency Medicine·Matteo Nicola Dario Di MinnoGiovanni Di Minno
Jul 31, 2012·Irish Journal of Medical Science·S McLeanA O'Gorman
Aug 13, 2003·Current Atherosclerosis Reports·Ulrich Laufs, James K Liao
Aug 13, 2003·Current Atherosclerosis Reports·Gregg C Fonarow
Jun 10, 2003·Current Atherosclerosis Reports·Cynthia A Sanoski
Feb 4, 2003·Current Atherosclerosis Reports·Joshua M Spin, Randall H Vagelos
Dec 10, 2003·Current Atherosclerosis Reports·Jean Davignon
Jun 25, 2005·Current Atherosclerosis Reports·Hashem M ShaltoniDavid C Hess
Aug 12, 2006·Current Atherosclerosis Reports·Anders G Olsson
Apr 18, 2008·Current Atherosclerosis Reports·Peter H Jones, John A Farmer
Nov 26, 2010·Current Atherosclerosis Reports·Andres Pineda, Luigi X Cubeddu
Jun 8, 2002·Current Cardiology Reports·Joshua M SpinUNKNOWN American Heart Association
Jun 8, 2002·Current Cardiology Reports·Lori MoscaUNKNOWN National Cholesterol Education Program
Apr 11, 2003·Current Treatment Options in Cardiovascular Medicine·Antonios M. Xydakis, Peter H. Jones
Mar 19, 2003·Lancet·Eric BoersmaMaarten L Simoons
Jun 14, 2003·Pharmacology & Therapeutics·Anthony S WierzbickiAlbert Ferro
Mar 23, 2007·The New England Journal of Medicine·Ashish M Kamat, Xifeng Wu
Sep 1, 2005·Journal of Palliative Medicine·Annette M VollrathJames Hallenbeck
Jun 7, 2006·Journal of Palliative Medicine·George F Davis
Jun 7, 2006·Journal of Palliative Medicine·David Currow, Amy P Abernethy
Mar 29, 2008·Metabolic Syndrome and Related Disorders·David Bell
Jul 31, 2008·European Heart Journal·Stella S DaskalopoulouSamy Suissa
Oct 23, 2003·The Journals of Gerontology. Series A, Biological Sciences and Medical Sciences·Wilbert S Aronow
Mar 30, 2005·International Anesthesiology Clinics·Jae Woo Lee
Dec 20, 2007·Journal of Cardiovascular Pharmacology·Ana M CastejonLuigi X Cubeddu
Feb 4, 2009·Journal of Cardiovascular Pharmacology·Timm BauerUNKNOWN Acute Coronary Syndromes Registry Investigators
Dec 25, 2007·Annals of Surgery·Trevor M Williams, Alden H Harken
Sep 11, 2009·The Journal of Trauma·Matthew D NealUNKNOWN Inflammation and Host Response to Injury Investigators
Jul 14, 2010·The Journal of Trauma·Mary D FogertyAdrian Barbul
Aug 23, 2006·Clinical and Experimental Pharmacology & Physiology·Hong-Wei YaoJian-Ping Zhu
Aug 22, 2006·Journal of General Internal Medicine·Chaim M BellAvi I Orner
Nov 21, 2002·Journal of Interventional Cardiology·Roberta A Sullivan, Peter A McCullough
Aug 19, 2011·The Journal of Pharmacology and Experimental Therapeutics·Marcus M Reidenberg
Apr 16, 2003·Heart·J Cramer
Aug 31, 2004·Cardiology·Kun-Tai LeeSheng-Hsiung Sheu
Oct 21, 2010·American Journal of Respiratory and Critical Care Medicine·Peter S KrugerBala Venkatesh
Jan 26, 2013·American Journal of Respiratory and Critical Care Medicine·Peter KrugerUNKNOWN ANZ-STATInS Investigators–ANZICS Clinical Trials Group

❮ Previous
Next ❯

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