Early statin therapy following ACS does not significantly reduce death, MI, stroke risk
MedWire News: A meta-analysis of randomized controlled trials (RCTs) suggests that early initiation of statin therapy after acute coronary syndrome (ACS) has no significant effect on the occurrence of adverse clinical outcomes.
"Initiation of statin therapy within 14 days following ACS produces favorable trends, but does not significantly reduce death, myocardial infarction (MI), or stroke up to 4 months after the index event," explain Matthias Briel (University Hospital Basel, Switzerland) and colleagues.
However, the team still recommends early statin treatment in patients hospitalized for ACS, because of the established long-term benefits of statin therapy on coronary artery disease.
To assess the short-term effects of early statin therapy, the researchers performed a meta-analysis involving 18 RCTs with a combined total of over 14,000 patients. Trials were included if statin treatment was initiated within 14 days of ACS onset and if follow-up was carried out for more than 30 days.
The analysis revealed no significant reductions in primary composite endpoints (death, MI, or stroke) or individual secondary endpoints (death from any cause, MI, stroke, cardiovascular death, revascularization procedures, unstable angina, and new or worsening heart failure) for patients treated early with statins, compared with patients receiving placebo or usual care, during the follow-up period.
There were favorable trends for each individual secondary endpoint relating to statin use, but only unstable angina risk at 4 months was significantly reduced by 24%, compared with controls.
Writing in the International Journal of Cardiology, the researchers say that adverse side effects with early stain therapy were rare, at 0.1%.
They report that "serious muscle toxicity was more common with early statin therapy than with placebo, but was rare and mostly limited to treatment with simvastatin 80 mg."
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By Nikki Withers