Full-dose Atorvastatin After Acute Coronary Syndrome (ACS) in Non-revascularisable Coronary Artery Disease

Full-dose Atorvastatin Versus Conventional Medical Therapy After Non-ST-elevation Acute Myocardial Infarction in Patients With Advanced Non-revascularisable Coronary Artery Disease

This study was designed to test the hypothesis that the addition of full-dose atorvastatin (80 mg/day) to conventional medical treatment could reduce ischaemic recurrences after non-ST-elevation acute myocardial infarction (NSTE-AMI) in patients with severe and diffuse coronary artery disease (CAD) not amenable to any form of mechanical revascularisation.

Inclusion Criteria:

• non-ST-segment elevation acute myocardial infarction.
• coronary angiography within 48 hours from admission.
• angiographic evidence of severe and diffuse coronary artery disease,not amenable to conventional direct revascularisation techniques by coronary artery bypass graft (CABG) or percutaneous coronary intervention (PCI).

Exclusion Criteria:

• ST-segment elevation acute myocardial infarction,
• clinical history of heart failure
• left ventricular ejection fraction <35%,
• any form of severe valvular dysfunction,
• previous implantation or indication to implant a cardioverter-defibrillator during the index admission,
• any increase in liver enzymes,
• history of any liver or muscle disease,
• renal failure with serum creatinine >2.5 mg/dL (221 mmol/L),
• need for continued use of intravenous medications to relieve anginal symptoms,
• presence of any major comorbidity with life expectancy <24 months.