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 .
Fluvastatin in the first-line therapy of acute coronary syndrome: results of the multicenter, randomized, double-blind, placebo-controlled trial (the FACS-trial)
Background Statins have been proved to be effective in reduction of mortality and morbidity when started in the early secondary prevention in stabilized patients after acute coronary syndrome ( ACS ) . The safety and efficacy of statin administration directly in the first-line therapy in unstable ACS patients is not clear . The aim of our study was , therefore , to assess the effect of statin treatment initiated immediately at hospital admission of patients with ACS . Methods The trial was stopped prematurely after enrollment of one hundred and fifty-six patients with ACS that were r and omized at admission to fluvastatin 80 mg ( N = 78 ) or placebo ( N = 78 ) . Study medication was administered immediately after r and omization and then once daily for 30 days ; all patients were then encouraged to continue in open-label statin therapy and at the end of one-year follow-up 75 % in the fluvastatin group and 78 % in the placebo group were on statin therapy . Results We did not demonstrate any difference between groups in the level of C-reactive protein , interleukin 6 , and pregnancy-associated plasma protein A on Day 2 and Day 30 ( primary endpoint ) . Fluvastatin-therapy , however , significantly reduced one-year occurrence of major adverse cardiovascular events ( 11.5 % vs. 24.4 % , odds ratio ( OR ) 0.40 , 95 % CI 0.17 - 0.95 , P = 0.038 ) . This difference was caused mainly by reduction of recurrent symptomatic ischemia ( 7.7 % vs. 20.5 % , OR 0.32 , 95 % CI 0.12 - 0.88 , P = 0.037 ) . Conclusions This study failed to prove the effect of fluvastatin given as first-line therapy of ACS on serum markers of inflammation and plaque instability . Fluvastatin therapy was , however , safe and it may reduce cardiovascular event rate that supports immediate use of a statin in patients admitted for ACS.Trial registration
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 .