Beginning use of statins within 14 days of acute coronary syndromes (such as heart attack or unstable angina) does not decrease the risk of death, heart attack, or stroke, for up to 4 months, based on a meta-analysis of previously published studies, according to an article in the May 3 issue of JAMA.

Numerous clinical trials and meta-analyses show that long-term therapy with statins reduces the risk of myocardial infarction (MI - heart attack), stroke, and death in patients at varying risks for cardiovascular disease, according to background information in the article. The short-term effects of early treatment with statins in patients after the onset of acute coronary syndrome (ACS, including MI or unstable angina) for these outcomes is unclear.

Matthias Briel, M.D., of the University Hospital Basel, Switzerland and colleagues conducted a meta-analysis of previous randomized controlled trials to determine whether early use of statins within 14 days following the onset of ACS reduces cardiovascular illness and overall death at 1 and 4 months. The researchers identified 12 trials involving 13,024 patients with ACS.

The researchers found that there were no statistically significant risk reductions from early statin therapy for total death, total MI, total stroke, cardiovascular death, fatal or nonfatal MI, or revascularization procedures (percutaneous coronary intervention or coronary artery bypass graft) at 1 month and 4 months of follow-up. The researchers add that serious adverse events associated with early initiation of statins are rare.

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(JAMA. 2006;295:2046-2056)

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Contact: Heiner C. Bucher, M.D., M.P.H.
JAMA and Archives Journals