Advanced

High Intensity Statin in Patient with Acute Coronary Syndrome, Why and How?

Author : Mohammad Saifur Rohman
Upload Date : 19-04-2018

Statins were introduced to clinical practice as lipid-lowering drugs for the treatment of high blood cholesterol levels. Their efficacy in secondary prevention was demonstrated in large prospective morbidity and mortality clinical trials involving patients with stable coronary artery disease (CAD). Later, statins may significantly contribute to plaque stabilization, reduction of thrombus formation and acceleration of fibrinolysis suggesting a rational use of statin in acute coronary syndrome (ACS).

 

Several randomized trials have demonstrated the safety and, in some cases, the efficacy of statin therapy if initiated early after the onset of ACS. Recent experimental studies, similar to the first clinical trials, have generated promising results that have supported the concept of the cardioprotective effect of statin administration as first-line therapy for ACS.

Furthermore, the previous study showed ACS patients with diabetes melitus, high intensity statin induced better long-term outcomes compared with moderate intensity. Several randomized controlled trials have also shown a benefit of high intensity statin treatment in reducing risk of death and second cardiovascular disease (CVD) events in patients previously diagnosed with an acute coronary syndrome (ACS).

 

The mechanism of these benefit showed by a meta-analysis involving 1623 participants from eight randomized-controlled trials and seven observational studies revealing that the benefits of high-intensity statin therapy on plaque regression occurred after 6 months [standardized mean difference (SMD): -0.27; 95% confidence interval (CI): -0.43 to -0.12; P=0.0006] and were sustained over 12 months (SMD: -0.14; 95% CI: -0.25 to -0.03; P=0.01).

How long high intensity statin used after an ACS, statin should be continued for at least 5 years. High-dose statin demonstrated a reduction in coronary events but dose reductions and higher discontinuation rates were also noted.

KEYWORDS : High intensity statin, acute coronary syndrome, plaque regression


Save Item
Download
Similar Articles

Clinical Picture and Risk Prediction of Short-Term Mortality of Mechanically Ventilated Patients Presented with Cardiogenic Shock in Intensive Cardiovascular Care Unit of Saiful Anwar General Hospital(H. A. Liemena*, F. W. Nugroho, D. H. Karimullah, Setyasih Anjarwani)

Right Ventricle Function as Predictor Inhospital Mortality in Acute Coronary Syndrome Patient’s in CCU Sarjito General Hospital (M. Suryantoro , H. P. Bagaswoto ,N. Taufiq , B. Y. Setianto)

Hemoglobine Level as Predictor of Inhospital Mortality in ACS Patients SCIENCE Registry Sub-Study(A. R. Gemilang, H. Purnasidha, N. Taufiq, B. Y. Setianto)

Profile of Dippers and Non Dippers Hypertension Patient in General Hospital Doctor Mohamad Saleh Probolinggo(M. A. Pasha; T. Ardhana)

Thrombocyte-to-Leukocyte Ratio is correlated with Length of Stay in Patients with ST-Elevation Myocardial Infarction Underwent Primary Percutaneous Coronary Intervention(Y.S. Pratama, R. Puspitoadhi, N.A. Tafriend, U. Bahrudin)

Association between Statin Use as Primary Prevention and Outcomes in Acute Coronary Syndrome Patients during 2016 in Cengkareng General Hospital, Jakarta(A. Priyana, A. F. Sunjaya, A. P. Sunjaya)

Diagnosing and Treating Left Bundle Branch Block ECG Finding as An Acute Coronary Syndrome Event in Rural Hospital of East Sumba: A Case Report(T.S.R. Sembiring)

Polycythemia Vera as the Main Risk Factor in ST Elevation Myocardial Reinfarction(W.D.S. Cyndiana, B. Kris, A. Wayan)

Pseudonormalization ST-segment in ST-elevation Myocardial Infarction Patient(F.Fathini, R. A. Seriulina,A. Ginanjar, T. T. Dewi, I.A. Rakhmawulan, D. Rostiati)

Left Ventricular Ejection Fraction in correlation with In Hospital Mortality in ACS Patients: SCIENCE Registry Sub-Study (B.A. Prabowo, H.P. Bagaswoto, N. Taufiq, B.Y. Setianto)

Definite Sub Acute Stent Thrombosis after Primary Percutaneous Coronary Intervention(G.Aditya, W. Aryadana)

Copyrights © 2018 ASMIHA | Managed by Indonesia Medical Event (IME)