Consider The Evidence: Med/Peds Journal Roundup

February 17, 2006

Statins alter initial presentation of CAD

Filed under: annals of internal medicine, CHD, statins — medblog @ 11:49 am

AnnalsIM 2/21 – Clearly statins reduce the risk of CAD, and act in several ways to prevent the formation of unstable plaques. So theoretically, the initial presentation of cardiac disease in patients on statins would be less likely to be unstable angina/MI vs. stable angina. In this weeks Annals, Go et al. present a study that supports just that conclusion. The study enrolled subjects whose first clinical presentation of coronary disease was either acute myocardial infarction or stable exertional angina. Patients presenting with myocardial infarction were much less likely to have received statins (19.3% vs. 40.4%) and beta-blockers (19.0% vs. 47.7%) than patients presenting with exertional angina. Although this is retrospective data, it seems very plausible that use of statins increases the odds that the presenting symptoms of cardiac disease are lower risk stable angina rather than higher risk ACS.


Go, Alan S. MD; Iribarren, Carlos MD, MPH, PhD; Chandra, Malini MS, MBA; Lathon, Phenius V.; Fortmann, Stephen P. MD; Quertermous, Thomas MD; Hlatky, Mark A. MD; for the Atherosclerotic Disease, Vascular Function and Genetic Epidemiology (ADVANCE) Study Statin and [beta]-Blocker Therapy and the Initial Presentation of Coronary Heart Disease. Annals of Internal Medicine. 144(4):229-238, February 21, 2006.


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