Based on moderate quality evidence , due to concerns about risk of bias and imprecision , initiation of statin therapy within 14 days following ACS does not reduce death , myocardial infa rct ion , or stroke up to four months , but reduces the occurrence of unstable angina at four months following ACS .
Serious side effects were rare
BACKGROUND The early period following the onset of acute coronary syndrome ( ACS ) represents a critical stage of coronary heart disease , with a high risk of recurrent events and deaths .
The short-term effects of early treatment with statins on patient-relevant outcomes in patients suffering from ACS are unclear .
This is an up date of a review previously published in 2011 .
OBJECTIVES To assess the effects , both harms and benefits , of early administered statins in patients with ACS , in terms of mortality and cardiovascular events .
A randomized, controlled trial of simvastatin versus rosuvastatin in patients with acute myocardial infarction: the Secondary Prevention of Acute Coronary Events – Reduction of Cholesterol to Key European Targets Trial
Aims We sought to evaluate reports that rosuvastatin 10 mg is a more efficacious treatment of hyperlipidaemia than is simvastatin 40 mg , hoping to assess this issue in the previously unstudied context of acute myocardial infa rct ion . Methods and results The Secondary Prevention of Acute Coronary Events - Reduction of Cholesterol to Key European Targets ( SPACE ROCKET ) Trial was an investigator-led , open-label , blinded-endpoint , multicentre , r and omized , controlled trial assessing the proportion of patients , at 3 months , achieving European Society of Cardiology 2003 ( ESC-03 ) lipid targets of total cholesterol ( TC ) less than 4.5 mmol/l ( 174 mg/dl ) or low-density lipoprotein cholesterol ( LDLc ) less than 2.5 mmol/l ( 97 mg/dl ) . Of 1263 patients r and omized , 77.6 % simvastatin versus 79.9 % rosuvastatin achieved ESC-03 targets [ odds ratio ( OR ) : 1.16 ; 95 % confidence interval ( CI ) : 0.88–1.53 ; P = 0.29 ] . There were statistically significant differences for simvastatin versus rosuvastatin , respectively , for mean LDLc 2.03 mmol/l ( 78 mg/dl ) versus 1.94 mmol/l ( 75 mg/dl ; P = 0.009 ) and also mean TC 3.88 mmol/l ( 150 mg/dl ) versus 3.75 mmol/l ( 145 mg/dl ; P = 0.005 ) . A post-hoc analysis showed higher achievement of the new ESC , American Heart Association and American College of Cardiology optimal lipid target of LDLc less than 1.81 mmol/l ( 70 mg/dl ) with rosuvastatin ( 45.0 % ) compared with simvastatin ( 37.8 % ; OR : 1.37 ; 95 % CI : 1.09–1.72 ; P = 0.007 ) . The proportion of patients achieving the Fourth Joint Task Force European Guidelines ( 2007 ) of TC less than 4.0 mmol/l ( 155 mg/dl ) and LDLc less than 2.0 mmol/l ( 77 mg/dl ) was 38.7 % for simvastatin 40 mg and 47.7 % for rosuvastatin 10 mg ( OR : 1.48 ; 95 % CI : 1.18–1.86 ; P = 0.001 ) . Conclusion We observed no superiority of either treatment for the ESC-03 lipid targets . Rosuvastatin 10 mg lowered mean cholesterol more effectively than simvastatin and achieved better results for the latest , more stringent , ESC target
Based on moderate quality evidence , due to concerns about risk of bias and imprecision , initiation of statin therapy within 14 days following ACS does not reduce death , myocardial infa rct ion , or stroke up to four months , but reduces the occurrence of unstable angina at four months following ACS .
Serious side effects were rare
BACKGROUND The early period following the onset of acute coronary syndrome ( ACS ) represents a critical stage of coronary heart disease , with a high risk of recurrent events and deaths .
The short-term effects of early treatment with statins on patient-relevant outcomes in patients suffering from ACS are unclear .
This is an up date of a review previously published in 2011 .
OBJECTIVES To assess the effects , both harms and benefits , of early administered statins in patients with ACS , in terms of mortality and cardiovascular events .