Early Statin Initiation and Outcomes in Patients With Acute Coronary Syndromes

Open Access
Publisher Website
Google Scholar
Abstract
The benefit of 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitors (statins) for cardiovascular disease secondary prevention has been clearly demonstrated.1-3 However, patients who had experienced acute coronary syndromes (ACS) in the previous 3 to 4 months were excluded from these studies. After patients are discharged from the hospital, the American College of Cardiology and the American Heart Association clinical practice guidelines for acute myocardial infarction (MI) and unstable angina recommend lipid-lowering therapy and a low-cholesterol diet for patients whose low-density lipoprotein cholesterol (LDL-C) levels are higher than 130 mg/dL (3.4 mmol/L), but the guidelines do not recommend initiating lipid-lowering therapy before hospital discharge.4,5 Similarly, the National Cholesterol Education Program's Adult Treatment Panel III report recommends that, in general, ACS patients with LDL-C levels of 130 mg/dL (3.4 mmol/L) or higher should be discharged taking drug therapy but recommends clinical judgment for lower levels and does not address initiating lipid-lowering therapy earlier.6