This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Contact me when this article is cited  Related Content  • Related articles  • Similar articles in JAMA  Topic Collections  • Nutritional and Metabolic Disorders  • Lipids and Lipid Disorders  • Cardiovascular System  • Cardiovascular Disease/ Myocardial Infarction  • Alert me on articles by topic  Social Bookmarking   What's this?

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

To the Editor: In his editorial¹ on statins in the treatment of ACS, Dr Nissen likely overstates the benefit and understates the risks of more aggressive therapy. All of the studies quoted had high dropout rates (10.8% for 16 weeks in the MIRACL trial; 31.7% for 2 years in the PROVE IT trial; and 32.8% for 2 years in the A to Z trial).^2-4 The broad composite clinical end points that were used in the atorvastatin studies were driven primarily by softer end points such as hospitalizations for unstable angina. Hard end points such as death or fatal and nonfatal myocardial infarctions were not affected by the more aggressive statin therapy (although longer study durations may have shown such an effect). These findings contrast with less aggressive therapies in the Scandinavian Simvastatin Survival Study⁵ (4S) and in the Cholesterol and Recurrent Events (CARE) trial⁶ in which hard end points . . . [Full Text of this Article]

William L. Isley, MD
isley.william@mayo.edu
Mayo Clinic
Rochester, Minn

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLES

Early Intensive vs a Delayed Conservative Simvastatin Strategy in Patients With Acute Coronary Syndromes: Phase Z of the A to Z Trial
, , , , , , , , , , , , , , , , and
JAMA. ;292():1307-1316.
FULL TEXT  

High-Dose Statins in Acute Coronary Syndromes

JAMA. ;293():36-36.
FULL TEXT  

High-Dose Statins in Acute Coronary Syndromes

JAMA. ;293():36-37.
FULL TEXT  

High-Dose Statins in Acute Coronary Syndromes

JAMA. ;293():37-37.
FULL TEXT  

High-Dose Statins in Acute Coronary Syndromes

JAMA. ;293():38-38.
FULL TEXT  

High-Dose Statins in Acute Coronary Syndromes--Reply
, , , , and
JAMA. ;293():38-39.
FULL TEXT  

High-Dose Statins in Acute Coronary Syndromes--Reply

JAMA. ;293():39-39.
FULL TEXT