domingo, 11 de octubre de 2009

Early statin therapy in ACS: What's the level of evidence?

Sep 28, 2009
Lisa Nainggolan
Los Angeles and San Francisco, CA -
A group of California cardiologists is questioning the strength of the evidence informing current US guidelines recommending the use of high-dose statin therapy early in the course of acute coronary syndrome (ACS)-
In a viewpoint and commentary article in the October 6, 2009 issue of the Journal of the American College of Cardiology, Dr Ryan P Morrissey (Cedars Sinai Medical Center, Los Angeles, CA) and colleagues say the current evidence is insufficient to support the class IA recommendation that is given to this indication by the ACC/AHA joint task force, a recommendation that has recently been elevated to a performance measure.
Senior author of the paper, Dr Sanjay Kaul (Cedars Sinai Medical Center), told heartwire that giving early intensive statin therapy in ACS before hospital discharge and regardless of the baseline level of LDL has been formally endorsed as a treatment guideline, "but there's never been any high-quality randomized evidence informing that recommendation." And therein lies the rub, he says, because since this advice is already given the highest recommendation, "there's no motivation for any one individual, sponsor, or professional body to pursue that kind of research, so that's a disservice."
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