Margaret A.WinkerMD, Deputy EditorIndividualAuthorPhil B.FontanarosaMD, Interim Co-EditorIndividualAuthor
In Reply: Clinical trials of
cholesterol-lowering therapy with inhibitors of HMG-CoA reductase
inhibitors or statins demonstrate an early time to benefit that extends
across the spectrum of absolute risk in patients with
(Table 1). In a reiteration of data from the 4S trial, Drs Kandzari and
Goldschmidt-Clermont illustrate differences in mortality according to
time of the acute coronary event.1 Although tests of
statistical significance are not provided, the authors suggest that
simvastatin has properties of "an efficient antiarrhythmic agent."
They cite unrelated studies on the regulatory role of polyunsaturated
fatty acids on Na+-Ca2+ exchange and
adenosine triphosphate–inhibited channels potassium and speculate that
simvastatin has membrane-stabilizing properties via this mechanism. To
our knowledge, there is no evidence to support this hypothesis.
Rosenson RS, Tangney CC. Coronary Events With Lipid-Lowering Therapy: The AFCAPS/TexCAPS Trial—Reply. JAMA. 1999;281(5):414-419. doi:10-1001/pubs.JAMA-ISSN-0098-7484-281-5-jbk0203