[The role of statins in secondary prevention of STEMI and NSTEMI: when to start with statin treatment?].
It has been reported that early use of statins in STEMI and NSTEMI as in acute coronary syndrome protects patients from recurrent ischemic events. Thus, it may reduce both short-term and long-term adverse outcomes such as subsequent cardiovascular mortality, myocardial infarction and revascularization, as well as stroke. It seems that this protective effect takes place as early as four months of treatment initiation, as reported in the MIRACL trial. The potential benefit slowly increases over time for up to 24 months of treatment initiation. Pleiotropic effects of statins, i.e. mechanisms such as improvement of endothelial dysfunction, antithrombotic and fibrinolytic as well as anti-inflammatory effects are possible explanations for this early effect. Therefore, the initiation of treatment with statins during hospitalization as part of acute phase therapy is advised. Relatively few patients need to be treated in such a way to prevent one death, so this approach is also cost-effective.
Reiner
Eljko
E
University Department of Medicine, Zagreb University Hospital Center, Zagreb, Croatia.
D054058:Acute Coronary Syndrome / Q000188:drug therapy; D004562:Electrocardiography; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage*; D009203:Myocardial Infarction / Q000503:physiopathology / Q000517:prevention & control*; D055502:Secondary Prevention
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors