High-Dose Statins in Acute Coronary Syndromes
- Bruce Ovbiagele, MD
-
ovibes@mednet.ucla.edu
Stroke Center and Department of Neurology
University of California
Los Angeles
Since this article does not have an abstract, we have provided the first 150 words of the full text.
- KEYWORDS:
- ACUTE CORONARY SYNDROMES
- HYDROXYMETHYLGLUTARYL-COA REDUCTASE INHIBITORS
- LIPOPROTEINS, LDL CHOLESTEROL
- PRAVASTATIN
- SIMVASTATIN
To the Editor: Although 2 randomized controlled trials previously evaluated the effect of early initiation of aggressive statin therapy following an acute coronary syndrome (ACS) event,1-2 the A to Z trial reported by Dr de Lemos and colleagues3 is the first randomized controlled trial to evaluate a strategy of early initiation of treatment with a statin compared with a delayed approach. The impact of any comparison of early with delayed initiation (intensive or not) in the carefully designed and controlled setting of a clinical trial is likely to be different in clinical practice. Several studies have shown that the practice of delayed initiation of lipid-lowering medications is not as effective as early initiation with regard to patient adherence to long-term therapy and the achievement of target national cholesterol guideline goals.4-5 There is a high likelihood that individuals intended to have delayed initiation would …
