Intensive statin therapy reduces mortality in ACS but not CHD
Fred Goldstein/Dreamstime.com
Patients with recent ACS should receive intensive statin therapy |
Intensive statin therapy reduces the risk of mortality more than moderate statin therapy in patients with acute coronary syndrome (ACS), a recent meta-analysis suggests (Heart
Online First, 3 February 2007).
Data from 28,350 patients were reviewed. The authors showed that patients
with recent ACS had a reduction in all-cause mortality over a mean follow-up
of two years (4.6 per cent to 3.5 per cent, odds ratio 0.75, 95 per cent
confidence interval 0.61–0.93).
Intensive statin therapy was also associated with fewer major adverse
cardiovascular events (0.84, CI 0.77–0.91) and fewer admissions
to hospital for heart failure (0.72, CI 0.62–0.83). However, for
patients with stable coronary heart disease (CHD) intensive statin therapy
was no better than moderate statin therapy for reducing all-cause mortality
over a mean of 4.7 years.
The authors say: “These findings suggest that intensive statin
therapy should be the standard of care in patients with recent ACS.”
HDL
cholesterol Researchers have quantified what changes in high-density
lipoprotein (HDL) cholesterol are seen in patients who experience reduction
in low-density
lipoprotein (LDL) cholesterol and regression of atherosclerosis in response to
statin therapy (JAMA 2007;297:499). In an analysis of four randomised
trials — involving
a total of 1,455 patients who underwent serial intravascular ultrasonography
while receiving a statin — reductions in atheroma volume of 5 per cent
or greater were observed in patients with LDL cholesterol levels below 2.3mmol/L
during treatment and with percentage increases of HDL cholesterol of more than
7.5 per cent (P<0.001).
However, the authors say that it is unknown whether the associations seen translate
into improved clinical outcomes. |
|
The
Pharmaceutical Journal
Acrobat
Reader