Pravastatin in acute ischaemic syndromes: Results of a randomised placebo-controlled trial

Therapy with individual 3-hydroxy-3-methylglutaryl coenzyme A reductase inh ibitors (statins) has been shown conclusively to diminish coronary event ra tes and mortality in both primary and secondary prevention. To date, scant attention has been paid to whether initiation of such regimens in the hospi tal phase of acute coronary syndromes might confer cardioprotective benefit s. The purpose of this study was to determine the safety and tolerability o f early initiation of statin therapy in patients with acute coronary syndro mes. In this randomised, double-blind, three-month, pilot study, 100 patien ts with acute myocardial infarction or unstable angina and low-density lipo protein cholesterol >3.5 mmol/l were randomly assigned to pravastatin 40 mg daily or placebo initiated within 48 hours of hospital admission. Pravasta tin proved safe and well tolerated in these patients, who were well matched at baseline. No statistically significant differences in death, MI and dru g-related adverse events were observed in the pravastatin group compared wi th control subjects. This pilot study shows that therapy with pravastatin e arly after an acute coronary event is safe and well tolerated. Larger, long -term studies are needed to confirm these findings.