The Myocardial Ischemia Reduction with Acute Cholesterol Lowering (MIRACL) trial: a new frontier for statins?

This approach is unlikely to be fruitful in MIRACL for several reasons: (1) baseline lipid measurements might have been transiently depressed owing to the acute coronary event; (2) lipid levels during treatment were first measured at 6 weeks, by which time many of the endpoint events had already occurred; (3) factors other than serum lipids have a greater effect on acute coronary syndromes than on stable coronary disease; and (4) the statistical power for subgroup analyses is low because the treatment effect was barely statistically significant for the whole trial.

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