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 .
Effect of intensive statin therapy on regression of coronary atherosclerosis in patients with acute coronary syndrome: a multicenter randomized trial evaluated by volumetric intravascular ultrasound using pitavastatin versus atorvastatin (JAPAN-ACS [Japan assessment of pitavastatin and atorvastatin 
OBJECTIVES The objective of this study was to evaluate whether the regressive effects of aggressive lipid-lowering therapy with atorvastatin on coronary plaque volume ( PV ) in patients with acute coronary syndrome ( ACS ) are generalized for other statins in multicenter setting . BACKGROUND A previous single-center study reported beneficial regressive effects of atorvastatin in patients with ACS on PV of the nonculprit site by intravascular ultrasound ( IVUS ) evaluation . The effect of statins other than atorvastatin on PV has not been evaluated in the setting of ACS . METHODS The JAPAN-ACS ( Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome ) study was a prospect i ve , r and omized , open-label , parallel group study with blind end point evaluation conducted at 33 centers in Japan . A total of 307 patients with ACS undergoing IVUS-guided percutaneous coronary intervention were r and omized , and 252 patients had evaluable IVUS examinations at baseline and 8 to 12 months ' follow-up . Patients were r and omly assigned to receive either 4 mg/day of pitavastatin or 20 mg/day of atorvastatin . The primary end point was the percentage change in nonculprit coronary PV . RESULTS The mean percentage change in PV was -16.9 + /- 13.9 % and -18.1 + /- 14.2 % ( p = 0.5 ) in the pitavastatin and atorvastatin groups , respectively , which was associated with negative vessel remodeling . The upper limit of 95 % confidence interval of the mean difference in percentage change in PV between the 2 groups ( 1.11 % , 95 % confidence interval : -2.27 to 4.48 ) did not exceed the pre-defined noninferiority margin of 5 % . CONCLUSIONS The administration of pitavastatin or atorvastatin in patients with ACS equivalently result ed in significant regression of coronary PV ( Japan Assessment of Pitavastatin and Atorvastatin in Acute Coronary Syndrome ; NCT00242944 )
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 .