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 pravastatin compared with placebo initiated within 24 hours of onset of acute myocardial infarction or unstable angina: the Pravastatin in Acute Coronary Treatment (PACT) trial.
BACKGROUND The efficacy of statin drugs after an acute coronary event is now well established , but the evidence for statin use in the early treatment of acute coronary events remains unclear . METHODS We tested the effects of administering pravastatin within 24 hours of the onset of symptoms in patients with unstable angina , non-ST-segment elevation myocardial infa rct ion , or ST-segment elevation myocardial infa rct ion . Patient recruitment of 10,000 with 1200 end points was planned , but the trial was stopped early . A total of 3408 patients were r and omly assigned to treatment with pravastatin ( 1710 patients ) or matching placebo ( 1698 patients ) .  Treatment was continued for 4 weeks . The primary end point of the study was a composite of death , recurrence of myocardial infa rct ion , or readmission to hospital for unstable angina within 30 days of r and om assignment . RESULTS The primary end point occurred in 199 of patients allocated to pravastatin ( 11.6 % ) and in 211 patients allocated to placebo ( 12.4 % ) . A relative risk reduction of 6.4 % favored allocation to pravastatin but was not statistically significant ( 95 % CI , -13.2 % to 27.6 % ) . No adverse effects were seen . CONCLUSIONS We conclude that 20 to 40 mg of pravastatin can be safely administered within 24 hours of the onset of symptoms of an acute coronary event , with a favorable but not significant trend in outcome at 30 days compared with placebo
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 .