Pharmacological treatment during AMI and in secondary prevention: the scientific evidence

Table 12. Hypolemic drugs (post infarct). Effect on mortality.
STUDIES DRUG No. PATIENTS FOLLOW-UP VAR. P
CORONARY DRUG PROJECT (1986) [12] NIACIN 3,908 15 YEARS - 11% 0.0004
4S (1994) [85] SIMVASTATIN 4,444 5.4 YEARS - 30% < 0.0003
CARE (1996) [84] PRAVASTATIN 4,159 5 YEARS - 24% < 0.003
LIPID (1998) [56] PRAVASTATIN 9,014 5 YEARS - 22% < 0.00002
 
META-ANALYSES No. STUDIES No. PATIENTS   VAR. P
ROSSOUW (1990) [81] 8 (diet also) 7,873   - 9% NS
MARCHIOLI (1998) [59] 39 31,122   -10%
- 22% statins		 0.002

 

ACC/AHA GUIDELINES

  • Class I:
    • pharmacological treatment in patients with LDL > 125 mg/dl
  • Class IIa:
    • in patients refractory to diet with LDL between 100 and 130 mg/dl
  • Class IIb:
    • with triglycerides > 400 mg/dl, therapy with niacin or gemfibrozil

ANMCO-SIC CLINICAL GUIDELINES

  • Therapy with statins in patients refractory to diet with total cholesterol > 240 mg/dl or < 240 mg/dl but with LDL > 125 mg/dl