or acute coronary syndrome," the authors write. "These benefits took more than four months to begin to accrue and were sustained for two years. During these two years, there was slightly less than a 20 percent reduction in the risk of experiencing an adverse coronary event." These results could not be explained by statins' cholesterol-lowering effects.

Overall, statins were about as safe and tolerable as the control treatments. Of the 17,963 patients, three developed a dangerous breakdown of muscle fibers, known as rhabdomyolysis; some studies showed a slightly higher risk of hepatitis among individuals taking statins. "Use of intensive statin therapy is often avoided by clinicians owing to fear of increased adverse events due to the higher statin dose or, in patients with only mild elevations in LDL-C [bad cholesterol] level, of driving LDL-C level below a theoretical safe value," the authors continue. "Our study showed that intensive statin therapy and controls experienced comparable rates of hepatitis, myositis and rhabdomyolysis. Serious adverse events were rare."

The statin regimen with the most evidence of effectiveness is an 80-milligram dose of atorvastatin, begun within 14 days of hospitalization for acute coronary syndrome, they conclude.

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Contact: Walter Reed Army Medical Center public affairs
202-782-7177
JAMA and Archives Journals
25-Sep-2006


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