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Healthy ageing: addressing acute coronary syndrome?

A. Gaw*

Clinical Trials Unit, Glasgow Royal Infirmary, Scotland, U.K.

* Correspondence: A. Gaw, MD, PhD, Director, Clinical Trials Unit, Glasgow Royal Infirmary, Scotland, G4 0SF, U.K.

Abstract

Acute coronary syndromes contribute significantly to the patterns of morbidity and mortality in the elderly. A meta-analysis of the pathology of acute myocardial infarction has shown that 80–90% of episodes result from the rupture of small, unstable lesions that cause <70% diameter stenosis. Statins have been shown to stabilize the architecture of atherosclerotic plaques in humans and in animals. Statin treatment has also been shown to restore endothelial function, inhibit platelet thrombus formation and exert an anti-inflammatory effect. Collectively, these data support the use of statin therapy in those at risk for acute coronary syndromes, of whom the elderly are foremost.

Key Words: acute coronary syndromes • atherosclerosis • 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) • pleiotropic effects • pravastatin

References

  1. American Heart Association. 1999 Heart and stroke statistical update. Dallas, Texas: American Heart Association; 1998.
  2. AnonymousExecutive Summary of the Third Report of the National Cholesterol Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285:2486–2497[Free Full Text]
  3. Falk E, Shah PK, Fuster V. Coronary plaque disruption. Circulation. 1995;92:657–671[Free Full Text]
  4. Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Study (4S). Lancet. 1994;344:1383–1389[CrossRef][Web of Science][Medline]
  5. West of Scotland Coronary Prevention Study Group. Influence of pravastatin and plasma lipids on clinical events in the West of Scotland Coronary Prevention Study (WOSCOPS). Circulation. 1998;97:1440–1445[Abstract/Free Full Text]
  6. Sacks FM, Pfeffer MA, Moye LA, et al. The effect of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. N Engl J Med. 1996;335:1001–1009[Abstract/Free Full Text]
  7. The Long-Term Intervention with Pravastatin in Ischaemic Disease (LIPID) Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med. 1998;339:1349–1357[Abstract/Free Full Text]
  8. Lewis SJ, Moye LA, Sacks FM, et al. Effect of pravastatin on cardiovascular events in older patients with myocardial infarction and cholesterol levels in the average range. Results of the Cholesterol and Recurrent Events (CARE) trial. Ann Intern Med. 1998;129:681–689[Abstract/Free Full Text]
  9. Aengevaeren WM. Beyond lipids: the role of the endothelium in coronary artery disease. Atherosclerosis. 1999;147(suppl 1):S11–S16
  10. Weissberg P. Mechanisms modifying atherosclerotic disease: from lipids to vascular biology. Atherosclerosis. 1999;147(suppl 1):S3–S10
  11. Williams JK, Sukhova GK, Herrington DM, Libby P. Pravastatin has cholesterol lowering independent effects on the artery wall of atherosclerotic monkeys. J Am Coll Cardiol. 1998;31:684–691[Abstract/Free Full Text]
  12. Crisby M, Nordin-Fredriksson G, Shah PK, Yano J, Zhu J, Nilsson J. Pravastatin treatment increases collagen content and decreases lipid content, inflammation, metalloproteinases, and cell death in human carotid plaques: implications for plaque stabilization. Circulation. 2001;103:926–933[Abstract/Free Full Text]
  13. Ridker P, Rifai N, Pfeffer MA, et al. Inflammation, pravastatin and the risk of coronary events after myocardial infarction in patients with average cholesterol levels. Circulation. 1998;98:839–844[Abstract/Free Full Text]
  14. Ridker P, Rifai N, Pfeffer MA, Sacks F, Braunwald E, Cholesterol and Recurrent Events (CARE) investigators. Long-term effects of pravastatin on plasma concentration of C-reactive protein. Circulation. 1999;100:230–235[Abstract/Free Full Text]
  15. Packard CJ, O'Reilly DS, Caslake MJ, et al. Lipoprotein associated phospholipase A2 as an independent predictor of coronary heart disease. West of Scotland Coronary Prevention Study Group. N Engl J Med. 2000;343:1148–1155[Abstract/Free Full Text]
  16. Shepherd J, Blauw GJ, Murphy MB, et al. The design of a prospective study of pravastatin in the elderly at risk (PROSPER). Am J Cardiol. 1999;84:1192–1197[CrossRef][Web of Science][Medline]

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This Article
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