MIRACL Study

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Objective

To assess whether early initiation of treatment with a statin can reduce the occurrence of these early events.

Methods

The Myocardial Ischemia Reduction with Acute Cholesterol Lowering (MIRACL) trial was a randomized, double-blinded trial wherein 3086 adults (18 years and above) with unstable angina or non-Q-wave MI were randomly assigned to receive treatment with atorvastatin (80 mg/day) or placebo between 24 and 96 hours after hospital admission and followed-up through 16 weeks. Primary predefined end point event was defined as time to death, nonfatal acute MI, cardiac arrest with resuscitation, or recurrent symptomatic myocardial ischemia with objective evidence and requiring emergency re-hospitalization.

Results

  • Primary end point occurred in 14.8% in patients treated with atorvastatin compared with 17.4% in the placebo group.
  • No significant differences in risk of death, nonfatal myocardial infarction, or cardiac arrest between the two groups.
  • Atorvastatin group had a lower risk of symptomatic ischemia with objective evidence and requiring emergency re-hospitalization.

Conclusion

After an acute coronary event early treatment with 80 mg/day atorvastatin reduces recurrent ischemic events in the first 16 weeks, mostly recurrent symptomatic ischemia requiring re-hospitalization.[1][2]

References

  1. Schwartz GG, Olsson AG, Ezekowitz MD; et al. (2001). "Effects of atorvastatin on early recurrent ischemic events in acute coronary syndromes: the MIRACL study: a randomized controlled trial". JAMA : the Journal of the American Medical Association. 285 (13): 1711–8. PMID 11277825. Unknown parameter |month= ignored (help)
  2. Schwartz GG, Oliver MF, Ezekowitz MD; et al. (1998). "Rationale and design of the Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering (MIRACL) study that evaluates atorvastatin in unstable angina pectoris and in non-Q-wave acute myocardial infarction". The American Journal of Cardiology. 81 (5): 578–81. PMID 9514453. Unknown parameter |month= ignored (help)