title: Statin therapy and the management of acute coronary syndromes.
abstract: The pathophysiology of acute coronary syndromes is related to erosion or rupture of vulnerable plaque leading to intracoronary thrombosis as a result of activation of the coagulation cascade and platelet aggregation. Potential benefit of hypolipidemic 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibition may be related to the pleiotropic effects such as endothelial function improvement, stabilization of the plaque in relation to reduced macrophage activity and smooth muscle cell proliferation, as well as other anti-inflammatory effects that have been demonstrated in animal models. With the publication of the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) study, early initiation of statin therapy within 24 to 96 h has been recognized as an important addition to the therapeutic armamentarium in the management of patients with acute coronary syndromes.
authors.affiliation: Canadian Heart Research Centre and St Michael's Hospital, University of Toronto, Toronto, Canada. langera@chrc.net
authors.forename: Anatoly
authors.initials: A
authors.lastname: Langer
authors.forename: Christian
authors.initials: C
authors.lastname: Constance
authors.forename: Jiri G
authors.initials: JG
authors.lastname: Fodor
authors.forename: Jiri J
authors.initials: JJ
authors.lastname: Frohlich
authors.forename: Jean
authors.initials: J
authors.lastname: Grégoire
authors.forename: David C W
authors.initials: DC
authors.lastname: Lau
authors.forename: Lawrence A
authors.initials: LA
authors.lastname: Leiter
authors.forename: G B John
authors.initials: GB
authors.lastname: Mancini
authors.forename: David
authors.initials: D
authors.lastname: Marr
authors.forename: Ruth
authors.initials: R
authors.lastname: McPherson
authors.forename: Blair J
authors.initials: BJ
authors.lastname: O'Neill
authors.forename: Simon W
authors.initials: SW
authors.lastname: Rabkin
mesh_terms: D000208:Acute Disease; D001777:Blood Coagulation / Q000187:drug effects; D003327:Coronary Disease / Q000188:drug therapy* / Q000378:metabolism / Q000503:physiopathology; D019468:Disease Management; D004730:Endothelium, Vascular / Q000378:metabolism / Q000503:physiopathology; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D010974:Platelet Aggregation / Q000187:drug effects; D013577:Syndrome
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors