Statins are
cholesterol-lowering drugs, highly effective in the primary and
secondary prevention of
coronary artery disease. It has been found, however, that
statins also have nonlipid effects; they can influence different pathways, which have been described to participate in the pathogenesis of
acute coronary syndrome (ACS).
Inflammation or decreased production of
nitric oxide are obvious targets for
statin therapy. Recently, several large clinical trials have been published, showing safety and, in some areas, efficacy of administration of
statins early after ACS. Furthermore, there is growing evidence from both experimental and small clinical studies that
statin therapy may have favourable effects when started as soon as possible after the development of ACS. Confirmation of this approach by large randomized trials is needed; however, based on currently available data,
statins have high chance of achieving a similar place in the first-line
therapy of ACS as the pillar of contemporary therapeutic strategy,
aspirin.