Angina Research Today is a free monthly online journal that collates and summarizes the latest research about Angina, including details on symptoms, treatment, causes, prevention, surgery.

In-hospital initiation of statin therapy in acute coronary syndromes: maximizing the early and long-term benefits.

Fonarow GC

Division of Cardiology, David Geffen School of Medicine at UCLA, Los Angeles, CA 90095-1679, USA. gfonarow@mednet.ucla.edu

Patients with acute coronary syndrome (ACS) are at high risk for recurrent coronary events, sudden death, and all-cause mortality. Conventional revascularization therapies reduce the risk of further ischemia but do not affect the underlying atherosclerotic disease. Statins have a proven record in the secondary prevention of coronary heart disease. Furthermore, statins have been shown to exert varying degrees of pleiotropic effects, which may stabilize vulnerable atherosclerotic plaques. A compelling body of evidence from randomized controlled trials demonstrates that high-dose, potent statin therapy initiated immediately after an acute coronary event can significantly reduce early as well as longer-term morbidity and mortality. Furthermore, high-dose, potent statin therapy displays a reasonable safety profile. National guidelines now recommend that in patients with ACS, statin therapy should be initiated in hospital prior to discharge, irrespective of baseline low-density lipoprotein cholesterol levels, to improve clinical outcomes. Every effort should be made to ensure all eligible patients with ACS are initiated and maintained on statin therapy.

Published 23 November 2005 in Chest, 128(5): 3641-51.
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