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The European Society of Cardiology

Do statins play a role in the early management of the acute coronary syndrome?

F.M Sacks*

Harvard School of Public Health and Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

* Frank M. Sacks, MD, Department of Nutrition, Harvard School of Public Health and Brigham and Women’s Hospital, Harvard Medical School, 655 Huntington Avenue, Boston, MA 02115, USA. Tel.: +1-617-432-1420; fax: +1-617-432-3101
fsacks{at}hsph.harvard.edu

Abstract

Acute coronary syndrome (ACS) is associated with a poor prognosis and, despite the availability of a number of treatment strategies, the incidence of subsequent serious complications following an acute event remains high. Although large, long-term clinical trials have established the benefits of statin therapy in the prevention of cardiovascular events and mortality, patients with recent ACS were excluded from these studies. Data from observational studies and a randomized controlled trial support the routine use of statins in ACS and highlight the association between early initiation and reductions in recurrent coronary events and mortality. Preclinical and clinical evidence also indicates that, in addition to their lipid-lowering effects, statins may reduce inflammation, improve endothelial function and increase plaque stability. Ongoing clinical trials with highly efficacious statins are expected to provide valuable information about the most appropriate agent and dose to improve the treatment of patients with ACS.

Key Words: Acute coronary syndrome • Myocardial infarction • Angina • Statins


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