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 .
Inflammation, pravastatin, and the risk of coronary events after myocardial infarction in patients with average cholesterol levels. Cholesterol and Recurrent Events (CARE) Investigators.
BACKGROUND We studied whether inflammation after myocardial infa rct ion ( MI ) is a risk factor for recurrent coronary events  and whether r and omized treatment with pravastatin reduces that risk . METHODS AND RESULTS A nested case-control design was used to compare C-reactive protein ( CRP ) and serum amyloid A ( SAA ) levels in prer and omization blood sample s from 391 participants in the Cholesterol and Recurrent Events ( CARE ) trial who subsequently developed recurrent nonfatal MI or a fatal coronary event ( cases ) and from an equal number of age- and sex-matched participants who remained free of these events during follow-up ( control subjects ) . Overall , CRP and SAA were higher among cases than control subjects ( for CRP P=0.05 ; for SAA P=0.006 ) such that those with levels in the highest quintile had a relative risk ( RR ) of recurrent events 75 % higher than those with levels in the lowest quintile ( for CRP RR= 1.77 , P=0.02 ; for SAA RR= 1.74 , P=0.02 ) . The study group with the highest risk was that with consistent evidence of inflammation ( elevation of both CRP and SAA ) who were r and omly assigned to placebo ( RR=2.81 , P=0.007 ) ; this risk estimate was greater than the product of the individual risks associated with inflammation or placebo assignment alone . In stratified analyses , the association between inflammation and risk was significant among those r and omized to placebo ( RR=2.11 , P=0.048 ) but was attenuated and nonsignificant among those r and omized to pravastatin ( RR=1.29 , P=0.5 ) . CONCLUSIONS Evidence of inflammation after MI is associated with increased risk of recurrent coronary events . Therapy with pravastatin may decrease this risk , an observation consistent with a nonlipid effect of this agent
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 .