Statins for acute coronary syndrome

Family Medicine, St Mary's Hospital, McGill University, 377 Rue Jean Brilliant, Montreal, Quebec, Canada, H3T 1M5.
Cochrane database of systematic reviews (Online) (Impact Factor: 6.03). 06/2011; 9(6):CD006870. DOI: 10.1002/14651858.CD006870.pub2
Source: PubMed


Long-term therapy with statins (for at least one year) has been shown to reduce the risk of heart attack, stroke, and all-cause mortality in patients with and without established coronary heart disease. The early period following an acute coronary syndrome is a critical stage of coronary heart disease, with a high risk of recurrent events and death. We aimed to determine if early initiation of statins improves patient-relevant outcomes within the first four months following an acute coronary syndrome. This review is an update of a review previously published in 2011 that included 18 studies, enrolling 14,303 patients. The update of this review did not identify any new studies for inclusion. We did not find a significant risk reduction for all-cause mortality, heart attack, or stroke within the first four months. We had some concerns about risk of bias and imprecision of the results. The risk of unstable angina was reduced by about 25% at four months following acute coronary syndrome. Serious side effects from early treatment with statins were rare (0.1%), and serious muscle toxicity was mostly observed with simvastatin 80 mg.

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