By combining data from nine randomized clinical trials and evaluating clinical outcomes individually rather than in combination, the analysis was able to put a sharper focus on the benefits of early statin therapy.
'We found that there was a benefit in what matters most--survival,' said Anthony Bavry, MD, a fellow in cardiovascular medicine at the Cleveland Clinic Foundation in Cleveland, OH.
The study involved data from more than 16,000 patients admitted to the hospital with ACS, a term that encompasses both unstable chest pain, or angina, and a particular form of heart attack. In each of the original studies, patients were randomly assigned to maximal-dose statin therapy during the hospital stay or to a more conservative approach that consisted of low-dose statin therapy or placebo.
Statins are primarily used to lower cholesterol levels in the blood, but they have other effects as well, including the ability to reduce inflammation in the arteries.
Dr. Bavry and his colleagues found that early, aggressive statin therapy reduced the risk of death by 22 percent and the risk of cardiovascular death by 25 percent, over a follow-up that averaged 15 months. Further analysis showed that for every 111 patients who were treated with early statin therapy, one life could be saved.
In addition, early statin therapy reduced the risk of another episode of unstable angina by 17 percent and the need to open a blocked coronary artery with a catheter-based procedure or coronary bypass surgery by 9 percent.
The improvement in survival was noticeable early on but became statistically certain only after six months of statin therapy. 'The benefits keep accruing,' Dr. Bavry said. 'Once a patient has acute coronary syndrome, there may not be a safe time to discontinue this medication.'