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Thursday, October 06, 2005

Prognosis and Effects of Intensive Statin Therapy After Acute Coronary Syndrome: Myocardial Ischemia Reduction with Statins

Entrez PubMed: "Relation of Characteristics of Metabolic Syndrome to Short-Term Prognosis and Effects of Intensive Statin Therapy After Acute Coronary Syndrome: An analysis of the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) trial.

Schwartz GG, Olsson AG, Szarek M, Sasiela WJ.

OBJECTIVE: We examined relations between characteristics of the metabolic syndrome, early cardiovascular risk, and effect of early, intensive statin therapy after acute coronary syndrome. RESEARCH DESIGN AND METHODS: A total of 3,038 patients in the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) trial were characterized by the presence or absence of a history of diabetes, a history of hypertension and/or blood pressure >/=130/>/=85, BMI >30 kg/m(2), HDL cholesterol <40 mg/dl (men) or <50 mg/dl (women), and triglycerides >/=150 mg/dl. Patients with three or more of these characteristics were categorized as having metabolic syndrome. RESULTS: A total of 38% of patients (n = 1,161) met criteria for metabolic syndrome as defined in this study and had a 19% incidence of a primary end point event (death, nonfatal myocardial infarction, cardiac arrest, or recurrent unstable myocardial ischemia) during the 16-week trial. Patients with two or fewer characteristics (n = 1,877) were classified as not having metabolic syndrome and had a 14% incidence of a primary end point event. In univariate analysis, the individual characteristics that bore a significant relation to risk were diabetes and low HDL cholesterol. In a multivariable model including age, sex, and randomized treatment ass"

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