Reduction with Aggressive Cholesterol Lowering (MIRACL) Study Investigators

BLOOD CHOLESTEROL LOWER-ing with statins has been re-garded as a long-term strategyto reduce death and ischemic cardiovascular events in patients with stable coronary heart disease, with sig-nificant effects evident after approxi-mately 2 years of treatment.1-3 Previ-ous trials excluded patients who had experienced recent unstable angina or acute myocardial infarction (MI). How-ever, it is within the early period after an acute coronary syndrome (ACS) that patients experience the highest rate of death and recurrent ischemic events.4,5 To date, it has not been determined whether initiation of treatment with a statin soon after an ACS can reduce the occurrence of these early events. Recent studies indicate that statins have salutary physiologic effects within weeks. In conjunction with lowering to-tal and low-density lipoprotein (LDL) cholesterol, statins may improve endo-Author Affiliations, Financial Disclosures, and MIRACL Study Investigators are listed at the end o