Commentary

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

David Waters¹ , Gregory G Schwartz² and Anders G Olsson³

¹  Division of Cardiology, Room 5G1, San Francisco General Hospital, 1001 Potrero Avenue, San Francisco, CA 94110, USA

²  Cardiology Section, Denver VA Medical Center, 1055 Clermont Street, Denver, CO 80220, USA

³  Department of Medicine Care, University Hospital, Linköping, S-58 185, Sweden

author email corresponding author email

Current Controlled Trials in Cardiovascular Medicine 2001, 2:111-114doi:10.1186/cvm-2-3-111

Published:	31 May 2001

Abstract

The Myocardial Ischemia Reduction with Acute Cholesterol Lowering (MIRACL) Trial tested the hypothesis that intensive lowering of cholesterol with atorvastatin (80 mg/day) initiated 24-96 h after an acute coronary syndrome would, over 4 months, reduce the incidence of the composite endpoint of death, nonfatal infarction, resuscitated cardiac arrest, and recurrent symptomatic myocardial ischemia with new objective symptoms requiring emergency rehospitalization. This primary composite endpoint was reduced from 17.4% to 14.8% (P = 0.048) among the 3086 patients enrolled. The results of MIRACL suggest that patients with acute coronary syndromes should begin to receive this treatment before leaving hospital, irrespective of baseline levels of low-density lipoprotein-cholesterol.