title: Rosuvastatin calcium in acute coronary syndromes.
abstract: BACKGROUND
  Low-density lipoprotein cholesterol (LDL-C) reduction using 3-hydroxy-3-methyl glutaryl coenzyme A (HMGCoA) reductase inhibitors (statins) has a proven survival benefit in patients presenting with acute coronary syndromes (ACS). Patients presenting with ACS remain at significant risk of subsequent cardiovascular death and non-fatal myocardial infarction despite high compliance with current guideline indicated secondary prevention therapies. There remains, therefore, a need to consider the potential benefits of more intensive LDL-C lowering after presentation with ACS. Rosuvastatin is the most potent of the currently available statins and has some unique pharmacological properties that may be advantageous in such patients.
  
  
  METHODS
  We conducted a Medline literature search to identify rosuvastatin papers and papers on statin use in ACS published in English. In this review, we outline the pharmacology of rosuvastatin and examine its efficacy and safety. We also evaluate the published trials of statin therapy in ACS and offer an opinion on the use of rosuvastatin in ACS.
  
  
  CONCLUSIONS
  There is adequate clinical trial evidence confirming the LDL-C lowering efficacy and safety of high-dose rosuvastatin in ACS. Whilst there are sound theoretical reasons to consider early use of high-dose rosuvastatin in ACS, the available level of evidence is insufficient to justify a wholesale change from the current standard of care.
authors.affiliation: Basildon University Hospital, Essex Cardiothoracic Centre, Cardiology, Basildon, UK. Rajesh.Aggarwal@btuh.nhs.uk
authors.forename: Rajesh K
authors.initials: RK
authors.lastname: Aggarwal
authors.forename: Refai
authors.initials: R
authors.lastname: Showkathali
mesh_terms: D054058:Acute Coronary Syndrome / Q000188:drug therapy* / Q000503:physiopathology; D000818:Animals; D008078:Cholesterol, LDL / Q000187:drug effects; D005464:Fluorobenzenes / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D009203:Myocardial Infarction / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D011743:Pyrimidines / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D000068718:Rosuvastatin Calcium; D055502:Secondary Prevention / Q000379:methods; D013449:Sulfonamides / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*
chemical_list: D008078:Cholesterol, LDL; D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011743:Pyrimidines; D013449:Sulfonamides; D000068718:Rosuvastatin Calcium