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 .
Lipid levels after acute coronary syndromes.
OBJECTIVES This analysis from the LUNAR ( Limiting UNdertreatment of lipids in ACS with Rosuvastatin ) study assessed lipid changes 1 to 4 days after onset of acute coronary syndromes ( ACS ) , before initiation of study treatment . BACKGROUND Early studies indicated that cholesterol levels decrease significantly after ACS . However , most studies were small or did not measure low-density lipoprotein cholesterol ( LDL-C ) directly , and many used nonfasting or retrospective data . More recent studies suggest less pronounced changes in cholesterol levels after ACS . METHODS The LUNAR trial is a prospect i ve , multicenter , r and omized , open-label study in adults hospitalized for acute ST-segment elevation myocardial infa rct ion ( STEMI ) , non-STEMI , or unstable angina ( UA ) . Blood sample s were taken at median times after onset of ACS symptoms of 26 h ( Day 1 , fasting or nonfasting sample ) , 43 h ( Day 2 , fasting sample ) , and 84 h ( Day 4 , fasting sample ) for direct measurement of serum lipid levels before study treatments were started . RESULTS Of 507 patients available for analysis , 212 were admitted for STEMI , 176 for non-STEMI , and 119 for UA . The LDL-C levels decreased in the 24 h after admission ( from 136.2 to 133.5 mg/dl ) , followed by an increase over the subsequent 2 days ( to 141.8 mg/dl ) . These changes did not seem to be clinical ly meaningful . Similar changes were observed for total cholesterol and smaller changes for high-density lipoprotein cholesterol ; fasting triglyceride levels did not change . CONCLUSIONS Mean lipid levels vary relatively little in the 4 days after an ACS and can be used to guide selection of lipid-lowering medication
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 .