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September 15, 2004

High-Dose Statins in Acute Coronary Syndromes: Not Just Lipid Levels

Author Affiliations

Author Affiliation: Department of Cardiology, Cleveland Clinic Foundation, Cleveland, Ohio.

JAMA. 2004;292(11):1365-1367. doi:10.1001/jama.292.11.1365

For more than a decade, statin drugs have accumulated a remarkable record of successful clinical trials, demonstrating robust evidence for reduction in clinical events, including myocardial infarction, stroke, and cardiovascular death in primary and secondary prevention populations.1-4 Recent trials have shown that intensive statin therapy is superior to moderate therapy for reducing morbidity following an acute coronary syndrome (ACS) event5,6 and for slowing the progression of coronary atherosclerosis.7 Statin trials have also demonstrated a favorable safety profile with only rare and isolated cases of serious toxicity.8 Given the spectacular success of this class of drugs, the failure of a statin clinical trial to meet its prespecified objective and evidence of an adverse safety profile are unusual and mandate careful analysis of potential responsible factors.