Extended-ESTABLISH trial: Early Statin Initiation Improves Long term Outcomes in ACS Patients

18 Aug, 10

Extended-ESTABLISH Trial

Objective

To determine whether the early initiation of statin therapy during ACS improves long-term prognosis.

Method

Prospective observational follow-up of the Early statin treatment in patients with acute coronary syndrome (ESTABLISH) trial.

Patient Number

N=180

Patients

Patients with ACS who underwent percutaneous coronary intervention (PCI).

Mean Follow-up Duration

4.2 years

Study Groups

Atorvastatin therapy: Intensive lipid lowering therapy with atorvastatin 20 mg/day immediately after PCI procedure.
Standard care group: A lipid lowering diet.

Primary Endpoint

Occurrence of Major Adverse Cardiovascular and Cerebrovascular events (MACCE) i.e. all cause death, recurrent ACS and stroke.

Results

Cumulative event-free survival was significantly higher in the atorvastatin group than in the control group (p=0.041).(Figure)

Figure: Cumulative event free survival in both groups.

Significant improvement in the lipid parameters in the atorvastatin group at 6 months follow-up.(Table)

Conclusion

Initiation of atorvastatin in ACS patients after percutaneous coronary intervention (PCI) lowers the risk for MACCE in the long term compared with more conservative treatment.

Atherosclerosis. 2010; 210: 497-502