Using the data from 18 available publications, we examined the efficacy in treating or reducing the risk of MI by using random-effects models of odds ratio (OR) comparing the highest with the lowest category
010)
Furthermore, a loading dose of atorvastatin remarkably reduced MACE, MI, and revascularization even after >30 days
Maintenance dose: 10 mg to 80 mg orally once a day
In our study, we compared the short-term effects of high (80 mg) vs moderate doses of atorvastatin (20 mg) in patients with STEMI undergoing primary percutaneous coronary intervention on endothelial function and vascular inflammation
3% between 2 and 12 hours)
By preventing the conversion of HMG-CoA to mevalonate, statin medications decrease cholesterol production in the liver
However, the association of high-dose statins with the incidence of the no-reflow phenomenon remains unclear
Interestingly, atorvastatin almost completely restored the survival signal in kidney cells
placebo with follow-up through 16 weeks
2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: the task force for the management of acute myocardial Shimomura M, Oyama J, Takeuchi M, et al
Atorvastatin is widely recommended for long-term secondary prevention in STEMI patients with no contraindication
low potency statins in ACS was examined by the Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis In Myocardial Infarction 22 (PROVE IT-TIMI 22) trial and other studies which demonstrated a dose-response relationship between LDL-c level and MACE (2,3)
Trial: EPHESUS
A high-intensity statin, defined as atorvastatin 40 or 80 mg and rosuvastatin 20 or 40 mg orally, which lowers low-density lipoprotein cholesterol (LDL-C) by ≥50%, is recommended by clinical practice guidelines for secondary prevention of cardiovascular (CV) events among patients who have an atherosclerotic CV disease (CVD; Class 1A)
The Pravastatin or Atorvastatin Evaluation and Infection Therapy - Thrombolysis in Myocardial Infarction 22 Trial randomized 4,162 patients with acute coronary syndrome to either atorvastatin 80 mg daily or pravastatin 40 mg daily (Cannon et al 2004)
Main Outcome Measure Occurrence of a major coronary event, defined as coronary death, confirmed nonfatal acute MI, or cardiac arrest with resuscitation
After a median follow-up period of two The inclusion criteria were: age from 18-85 years, diagnosis of acute myocardial infarction with ST elevation less than 12 h of evolution (symptoms, The time between loading dose of atorvastatin and primary PCI ranged from ≤90-150 min in our study
The guideline aims to improve survival and quality of life for people who have a heart attack or unstable angina As a consequence, intensive atorvastatin treatment during acute myocardial infarction could reduce clinical events by anti-inflammatory effects
During one-year post-PCI follow up, none died
08%) and overall non Aspirin should be given with a loading dose of 250-500 mg, followed by 75-100 mg/day
Acute ST-segment elevation myocardial infarction (STEMI) is a serious and multiple acute cardiovascular disease
PROVE IT-TIMI 22 Investigators
Short‐term high‐dose atorvastatin pretreatment significantly reduced the incidence of MACEs at 30‐day follow‐up (risk ratio [RR] 0
Full-dose atorvastatin versus conventional medical therapy after non-ST-elevation acute myocardial infarction in patients with advanced non-revascularisable coronary artery disease
Changes in the absolute number of Statins in the Prevention of Cardiovascular Disease and Heart Failure
Findings In this secondary analysis of a randomized clinical trial, the rate of 30-day major adverse cardiovascular events was 6
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Initial dose: 10 mg or 20 mg orally once a day
In fact, in patients with acute coronary syndromes, rapid and major lowering of LDL cholesterol levels (−29%) was observed after just 5 days of treatment with high-dose statin
For oral dosage form (tablets and suspension): For high cholesterol: Adults—At first, 10 or 20 milligrams (mg) once a day
In our study, we compared the short-term effects (after 1 month) of early administration of high-dose atorvastatin (80 mg) and a moderate dose of the same
Atorvastatin competitively inhibits 3-hydroxy-3-methylglutaryl-coenzyme A (HMG-CoA) reductase
High-dose atorvastatin
Two large prospective randomized studies, the Heart Protection Study (simvastatin at 40 mg/day) and Stroke Prevention by Aggressive Cholesterol Reduction (SPARCL; atorvastatin at 80 mg) demonstrated that high-dose statins can be used safely over prolonged periods of time
low potency statins in ACS was examined by the Pravastatin or Atorvastatin Evaluation and Infection Therapy-Thrombolysis In Myocardial Infarction 22 (PROVE IT-TIMI 22) trial and other studies which demonstrated a dose-response relationship between LDL-c level and MACE (2,3)
found that even a short-term pretreatment with a high dose of atorvastatin (80 mg 12 h before PCI, with a further 40 mg preprocedure dose) could reduce the 30 day incidence of MACEs in Chinese patient with non-ST elevation ACS (2
4%
Interventions Patients were randomly assigned to receive a high dose of atorvastatin (80 mg/d; n = 4439), or usual-dose simvastatin (20 mg/d; n = 4449)
Main outcomes and measures: The primary outcome was MACE through 30 days, composed by all-cause mortality, myocardial infarction, stroke, and unplanned coronary
and MI
Some summary points from NICE guidance concerning use of statin treatment post myocardial infarction (1): statin therapy is recommended for adults with clinical evidence of cardiovascular disease
However, the dose is usually not more than 80 mg per day
0mmol per litre, the dose of simvastatin could be increased to As compared with the group given 10 mg of atorvastatin, the group given 80 mg had a 22 percent relative reduction in the primary composite efficacy outcome of death from CHD, nonfatal non High-dose atorvastatin pretreatment was proved reducing the risk of contrast-induced acute kidney injury (CI-AKI), especially in patients with high C-reactive protein (CRP) levels
Objective To compare the effects of atorvastatin 10 mg versus 40 mg in circulating angiogenic cell mobilisations and in restoring coronary flow reserve (CFR) during the 8-month follow-up in patients with a first acute myocardial infarction (AMI)
Maximum dose: 80 mg/day