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 .
Diabetes mellitus is a major negative determinant of coronary plaque regression during statin therapy in patients with acute coronary syndrome--serial intravascular ultrasound observations from the Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome Trial (the JAPAN-ACS Tria
BACKGROUND The Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome ( JAPAN-ACS ) trial has found that early aggressive statin therapy in patients with acute coronary syndrome ( ACS ) significantly reduces the plaque volume ( PV ) of non-culprit coronary lesions . The purpose of the present study was to evaluate clinical factors that have an impact on plaque regression using statin therapy . METHODS AND RESULTS Serial intravascular ultrasound observations over 8 - 12 months were performed in 252 ACS patients receiving pitavastatin or atorvastatin .  Linear regression analysis identified the presence of diabetes mellitus ( DM ) and PV at baseline as inhibiting factors , and serum remnant-like particle-cholesterol level at baseline as a significant factor significantly affecting the degree of plaque regression . Significant correlation between % change of PV and low-density lipoprotein cholesterol ( LDL-C ) level was found in patients with DM ( n=73 , P<0.05 , r=0.4 ) , whereas there was no significant correlation between the 2 parameters in patients without DM ( n=178 ) . CONCLUSIONS The regression of coronary plaque induced by statin therapy after ACS was weaker in diabetic patients than their counterparts . Moreover , vigorous reduction of the LDL-C levels might induce a greater degree of plaque regression in ACS patients with DM
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 .