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 .
Intensive cholesterol lowering with statin improves the outcomes of percutaneous coronary intervention in patients with acute coronary syndrome.
BACKGROUND The incidence of no reflow phenomenon limits the clinical outcomes of percutaneous coronary intervention  ( PCI )  . This r and omized controlled study was design ed to evaluate the immediate protective effects of intensive statin pretreatment on myocardial perfusion and myocardial ischemic injury during PCI . METHODS Altogether 228 patients with acute coronary syndrome ( ACS ) were r and omly assigned to st and ard statin group ( SS group , n = 115 ) and intensive statin group ( IS group , n = 113 ) . Patients in the SS group received 20 mg simvastatin and patients in the IS group received 80 mg simvastatin for 7 days before PCI .  Thrombolysis in myocardial infa rct ion ( TIMI ) flow grade ( TFG ) , corrected TIMI frame count ( CTFC ) and TIMI myocardial perfusion grade ( TMPG ) of the intervened vessel were recorded before and after stent deployment . Creatine kinase ( CK ) isoenzyme MB , troponin I and plasma level of high sensitive-C reactive protein ( hs-CRP ) , P-selectin and intercellular adhesion molecule ( ICAM ) were measured before and 24 hours after the procedure . RESULTS The TFG after stent deployment was significantly improved with less TIMI 0 - 1 and more TIMI 3 blood flow in the IS group than in the SS group ( all P < 0.05 ) . Patients with no reflow phenomenon were less in the IS group ( P < 0.001 ) . The CTFC was lower in the IS group than in the SS group ( P < 0.001 ) . TMPG was also improved in the IS group than in the SS group ( P = 0.001 ) . Although PCI caused a significant increase in CK-MB 24 hours after the procedure , the elevated CK-MB value was lower in the IS group than in the SS group ( 18.74 + /- 8.41 vs 21.78 + /- 10.64 , P = 0.018 ) . Similar changes were also found in troponin I ( 0.99 + /- 1.07 in the IS group vs 1.47 + /- 1.54 in the SS group , P = 0.006 ) . CK-MB elevation occurred in 27.8 % ( 32/115 ) of the patients in the SS group vs 15.9 % ( 18/113 ) in the IS group ( P = 0.030 ) . Myocardial necrosis was detected in 4.4 % ( 5/115 ) of the patients in the SS group , whereas 0.9 % ( 1/113 ) in the IS group ( P = 0.341 ) . But no myocardial infa rct ion was found . Similarly , the patients with increased level of troponin I were much more in the SS group ( 36.5 % , 42/115 ) than in the IS group ( 19.5 % , 22/113 ) ( P = 0.04 ) . Among them , myocardial necrosis was detected in 13.0 % ( 15/115 ) of the patients in the SS group , while 4.4 % ( 5/113 ) in the IS group ( P = 0.021 ) . Myocardial infa rct ion was found in 4.4 % ( 5/115 ) of the patients in the SS group and 0.9 % ( 1/113 ) in the IS group ( P = 0.213 ) . CONCLUSIONS Intensive statin pretreatment for 7 days before PCI can further improve myocardial blood perfusion , protect the myocardium from ischemic injury . These effects are associated with the lowered levels of hs-CRP , P-selectin and ICAM
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 .