Statins in the management of acute coronary syndrome

HMG-CoA reductase inhibitors(statins) are widely used to treat dyslipidemia, and now play an important role in the management of acute coronary syndrome (ACS). Besides their lipid lowering effect, statins display 'pleiotropic effects' that include improvement of nitric oxide bioavailability, inhibition of inflammatory cytokine expression and inhibition of blood coagulability, which may ameliorate the pathogenesis of ACS as shown in animal models and human studies. In clinical trials, statins are proven to reduce the risk of ACS in primary as well as secondary prevention, in which LDL cholesterol lowering correlates with the risk reduction for ACS. Recent trials suggested that the immediate initiation of statins benefit the ACS patients reducing recurrent ischemic events and improve prognosis. These evidences suggest that more aggressive statin treatment may benefit both low- and high-risk patients in the management of ACS.