Abstract
BackgroundWhether high-intensity statin treatment provides more clinical benefits compared with standard statin regimens in acute coronary syndrome (ACS) patients remains controversial. This meta-analysis aimed to comparatively assess high-intensity and standard statin regimens for efficacy and safety in patients with ACS.MethodsThe PubMed, EMBASE, and Cochrane Library databases were searched for studies assessing high-intensity vs. standard statin regimens for ACS treatment from inception to April 2020. The publication language was limited to English, and 16 randomized controlled trials were finally included in this study, with a total of 26,497 patients.ResultsCompared to the standard statin regimens, the relative ratio (RR) of major adverse cardiovascular events (MACE) in ACS patients treated by high-intensity statin was 0.77 (95%CI, 0.68–0.86; P < 0.00001; prediction interval, 0.56–1.07). In subgroup analysis, high-intensity statin therapy resulted in more clinical benefits regarding MACE compared with standard statin treatment in both Asian (RR = 0.77; 95%CI, 0.61–0.98; P = 0.03) and non-Asian (RR = 0.79; 95%CI, 0.71–0.89; P < 0.0001) patients. Although adverse events were acceptable in patients with ACS administered high-intensity statin therapy, this treatment was associated with a higher rate of adverse events (4.99% vs. 2.98%), including myopathy/myalgia and elevated liver enzymes, as reflected by elevated serum aminotransferase or aminotransferase amounts.ConclusionThe current findings indicated that high-intensity statin therapy might be beneficial in patients with ACS, and close monitoring for adverse effects should be performed.
Highlights
Numerous studies have shown that 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors reduce the risk of death and cardiovascular events in acute coronary syndrome (ACS) cases [1, 2]
Studies that were not included in the latter metaanalysis reported discrepant findings, claiming that highintensity statin treatment has no significant effect on major adverse cardiovascular events (MACE) reduction in ACS cases in comparison with standard statin administration [6, 7]
High-intensity statin was defined as atorvastatin administered at 40–80 mg, rosuvastatin at 20–40 mg, or simvastatin at 80 mg, i.e., medication amounts higher than the standard doses described in recent guidelines [8, 9]
Summary
Numerous studies have shown that 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) reduce the risk of death and cardiovascular events in acute coronary syndrome (ACS) cases [1, 2]. Yu et al Lipids in Health and Disease (2020) 19:194 treatment confers more clinical benefits compared with standard statin therapy in patients with ACS remains controversial, the previous Prove-it trial indicated high-intensity statin therapy further reduces MACE [4]. Studies that were not included in the latter metaanalysis reported discrepant findings, claiming that highintensity statin treatment has no significant effect on MACE reduction in ACS cases in comparison with standard statin administration [6, 7]. Because of the above controversial findings, the present meta-analysis of randomized controlled trials (RCTs) was performed to comparatively evaluate highintensity and standard statin regimens for efficacy and safety in patients with ACS. Whether high-intensity statin treatment provides more clinical benefits compared with standard statin regimens in acute coronary syndrome (ACS) patients remains controversial.
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
