MIRACL study, atorvastatin

Summary points regarding this study are presented:

• objective - to determine whether atorvastatin, 80 mg/d, initiated 24-96 hours after an acute coronary syndrome, reduces death and nonfatal ischaemic events
• trial design - randomized double-blind, follow-up through 16 weeks
• patients - 3086 patients (aged 18 years or older) with unstable angina or nonQ-wave acute myocardial infarction
• main outcome measures - primary end point defined as death, nonfatal acute myocardial infarction, recurrent myocardial ischaemia with objective evidence and requiring emergency hospitalisation, or cardiac arrest with resuscitation
• results - no significant differences in risk of death, nonfatal myocardial infarction, or cardiac arrest between the atorvastatin group and the placebo group, although the atorvastatin group had a lower risk of symptomatic ischaemia with objective evidence and requiring hospitalisation (6.2% Vs 8.4%; RR, 0.74; 95% CI, 0.57-0.95; P=.02)
• conclusion - lipid lowering treatment with atorvastatin, 80mg/d, for patients with acute coronary syndrome, reduces ischaemic events in the first 16 weeks, mostly recurrent symptomatic ischaemic requiring hospitalisation

Reference:

1. Schwartz GC et al. Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes - the MIRACL Study: A randomized controlled trial. JAMA 2001; 285 (13): 1711-1718.