Calc Function

    • Calcs that help predict probability of a diseaseDiagnosis
    • Subcategory of 'Diagnosis' designed to be very sensitiveRule Out
    • Disease is diagnosed: prognosticate to guide treatmentPrognosis
    • Numerical inputs and outputsFormula
    • Med treatment and moreTreatment
    • Suggested protocolsAlgorithm





    Chief Complaint


    Organ System


    Patent Pending

    MIRACL Trial (2001): Atorvastatin use for early recurrent ischemic events in ACS


    MIRACL Trial - atorvastatin in acute coronary syndrome

    2001, Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL study: a randomized controlled trial. JAMA

    MIRACL Trial Key Points:

    1. In addition to lowering the cholesterol and LDL levels, statins have been coined to lower the platelet aggregability, thrombus deposition and vascular inflammation as well.
    2. This observation led to the hypothesis that statins might be useful in lowering the recurrence of ischemic events after UA or NSTEMI.
    3. The MIRACL trial tested this hypothesis and showed 2.6% absolute reduction in recurrent ischemic events after early initiation of atorvastatin in patients who presented with UA or NSTEMI.

    GuidelinesĀ changes

    The 2014 ACC/AHA guidelines on NSTEMI recommends:

    Initiate or continue high-intensity statin therapy in patients with no contraindications (Grade I, LOE: A)

    Obtain a fasting lipid profile, preferably within 24 h (Grade IIa, LOE: C)