[The place of statins in acute coronary accidents].
Statin therapy significantly decreases the rate of clinical events in secondary prevention, however their use in patients with the acute phase of acute coronary syndromes remains controversial. Their pleiotropic effects on thrombosis, inflammation, and endothelial dysfunction, might improve vascular healing. Although numerous observational studies have shown a significant reduction in mortality, one trial suggested that the statins may have a potentially harmful effect in patients with low cholesterol. However, randomised controlled trials have not demonstrated harmful effects. Of these trials, the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) study is the only trial with adequate statistical power to show a significant reduction in ischemic events at 16 weeks with a high dose of once daily atorvastatin 80 mg.
Lablanche
Jean-Marc
JM
Service de Cardiologie B et Hémodynamique, Hôpital Cardiologique, CHRU de Lille, Lille, France. jeanmarc.lablanche@free.fr
D000208:Acute Disease; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000188:drug therapy* / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000627:therapeutic use*
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors