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:
- 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.
- This observation led to the hypothesis that statins might be useful in lowering the recurrence of ischemic events after UA or NSTEMI.
- 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.
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)http://www.ncbi.nlm.nih.gov/pubmed/25260718