Long-term management of patients with unstable angina and NSTEMI

This recommendation is based in part on the MIRACL trial, in which 3086 acute coronary syndrome patients treated with atorvastatin, 24 to 96 hours after hospital admission, demonstrated a significant reduction in the composite rate of death, nonfatal MI, resuscitated cardiac arrest, or recurrent ischemia compared with those who received placebo (14.8% vs 17.4%) (RR=0.84; 95% CI, 0.70–1.00; P=.048). Patients were followed for up to 16 weeks after starting therapy. Abnormal liver transaminases (>3 times upper limit of normal) occurred more often in the atorvastatin group than the placebo group (2.5% vs 0.6%; P<.001).⁸

Correspondence
John S. Banas, MD, FACC, Morristown Memorial Hospital, 100 Madison Ave, Morristown, NJ 07960. E-mail: john.banas@ahsys.org.