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 .
Comparison of lipid-modifying efficacy of rosuvastatin versus atorvastatin in patients with acute coronary syndrome (from the LUNAR study).
Patients with acute coronary syndrome are recommended for early aggressive low-density lipoprotein ( LDL ) cholesterol-lowering therapy . The LUNAR study compared the efficacy of rosuvastatin with that of atorvastatin in decreasing LDL cholesterol in patients with acute coronary syndrome . Adult patients with coronary artery disease who were hospitalized for an acute coronary syndrome within 48 hours of first symptoms were r and omized ( n = 825 ) to an open-label , once-daily treatment with rosuvastatin 20 mg ( RSV20 ) , rosuvastatin 40 mg ( RSV40 ) , or atorvastatin 80 mg ( ATV80 ) for 12 weeks . Patients were evaluated at weeks 2 , 6 , and 12 . The primary end point was treatment efficacy in lowering LDL cholesterol averaged over 6 to 12 weeks . Changes in other lipoproteins , including high-density lipoprotein ( HDL ) cholesterol , and safety were evaluated . Analysis of covariance was used to compare least squares mean differences between each rosuvastatin treatment arm and the atorvastatin arm . The efficacy of RSV40 in lowering LDL cholesterol was significantly greater than that of ATV80 ( 46.8 % vs 42.7 % decrease , p = 0.02 ) . LDL cholesterol lowering by RSV20 was similar to that by ATV80 . Increases in HDL cholesterol were significantly greater with RSV40 ( 11.9 % , p < 0.001 ) and RSV20 ( 9.7 % , p < 0.01 ) than with ATV80 ( 5.6 % ) . RSV40 was also significantly more effective than ATV80 in improving most other secondary efficacy variables , whereas the effects of RSV20 on these parameters were generally similar to those of ATV80 . All 3 treatments were generally well tolerated over 12 weeks . In conclusion , results from the LUNAR study show that RSV40 more effectively decreased LDL cholesterol , increased HDL cholesterol , and improved other blood lipid parameters than ATV80 in patients with acute coronary syndrome
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 .