Rosuvastatin: a review of the pharmacology and clinical effectiveness in cardiovascular disease.

54 The A to Z study which compared 40 mg and 80 mg of simvastatin demonstrated a benefit which did not reach statistical significance, while the MIRACL (Myocardial Ischaemia Reduction with Aggressive Cholesterol Lowering) study showed that early intensive treatment with atorvastatin 80 mg after ACS led to a 16% reduction in death, acute MI, unstable angina and cardiac arrest, compared with placebo. 55 Meta-analyses of intensive statin trials have also shown that intensive treatment provides benefit above lower intensity treatment in prevention of myocardial infarction and strokes in patients with known coronary disease irrespective of the baseline LDL-C.

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