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 .
Rosuvastatin induces apoptosis in CD4+CD28null T cells in patients with acute coronary syndromes
Aims CD4+CD28null cells represent an aggressive and long-living T cell sub population , capable of infiltrating atheromatous plaque , leading to destabilisation and result ing in acute coronary syndromes ( ACS ) . The aim of this study was to evaluate whether statins decrease the number of circulating CD4+CD28null T cells by apoptosis in patients with ACS . Methods and results Patients with troponin-positive ACS ( n = 35 ) without cholesterol lowering drugs were r and omised to  placebo  ( n = 17 ) or rosuvastatin 20 mg ( n = 18 ) once daily for 6 weeks . CD4+CD28null T cell abundance ( > 1 % ) was distributed equally among the two groups at entry ( n = 10 per group ) . Within 72 h rosuvastatin treatment significantly reduced mean CD4+CD28null T cell numbers ( 37 × 106/L vs. placebo 122 × 106/L , n = 20 , P = 0.041 ) , IFN-γ production ( 62.6 vs. 101.5 % , P = 0.049 ) and increased apoptosis of these T cells ( 63.4 vs. 12.3 % , P < 0.001 ) . The intrinsic mitochondria-dependent pathway measured by the anti-apoptotic protein expression of B cell lymphoma 2 ( BCL-2 ) was significantly down-regulated ( mean fluorescence intensity 16.08 vs. placebo 43.34 , P < 0.001 ) . Conclusions The down-regulation of anti-apoptotic BCL-2 expression by statins  induces apoptosis in CD4+CD28null T cells . Targeting CD4+CD28null T cells in ACS statins could provide one further therapeutic strategy to prevent acute life-threatening coronary events
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 .