Early Statin Therapy May Reduce Unstable Angina

Risk of death, heart attack, or stroke is not reduced by statins after acute coronary syndromes

TUESDAY, June 21 (HealthDay News) -- Early statin therapy following acute coronary syndromes (ACS) may reduce the risk of unstable angina at four months, but does not significantly reduce the risk of all-cause mortality, myocardial infarction (MI), or stroke, according to a review published in the June issue of the Cochrane Database of Systematic Reviews.

Noah Vale, M.D., from McGill University in Montreal, and colleagues reviewed available literature to evaluate the benefits and harms of early statin therapy in 14,303 patients with ACS. Treatment effects were measured from data collected from 18 randomized controlled trials comparing statins with placebo or routine care, and initiation of statin therapy within 14 days of ACS onset with a follow-up of at least 30 days reporting at least one clinical outcome.

The investigators found that there were no differences in primary outcome of death, non-fatal MI, and stroke with early statin therapy compared to placebo or usual care at one- and four-month follow-ups. Statin use did not result in significantly reduced risks of total death, MI, stroke, cardiovascular death, revascularization procedures, or acute heart failure at one and four months, although statin use was associated with favorable trends for these end points. At four months following ACS, the risk of unstable angina was significantly reduced (risk ratio, 0.76). There were nine patients with myopathy from the statin group compared to one from the control group; serious muscle toxicity was largely limited to treatment with 80 mg simvastatin.

"Based on available evidence, initiation of statin therapy within 14 days following ACS does not reduce death, MI, or stroke up to four months, but reduces the occurrence of unstable angina at four months following ACS," the authors write.

Several of the study authors disclosed financial ties to the pharmaceutical industry.

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