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PROVE-IT TIMI 22 Study: potential effects on critical pathways for acute coronary syndrome.

Acute coronary syndrome (ACS), defined as acute myocardial infarction (MI) or unstable angina (UA), is a major cause of morbidity and mortality, and is the most prevalent cause of death in patients who have been hospitalized for the treatment of medical conditions. In the United States alone, more than 1.9 million suspected cases of UA or acute MI occur each year, and approximately 515,000 deaths annually from coronary heart disease (CHD). Most fatalities after acute MI or UA occur within the first 30 days; however, by 90 days, death rates are comparable with those of patients with stable angina (Fig. 1). Therefore, maximizing therapeutic protection immediately after ACS is important in this patient population. Recent advances in treatment, including antiplatelet and antithrombotic therapy, have reduced ACS-related morbidity and mortality. New guidelines incorporating these treatments have been published by the American College of Cardiology and the American Heart Association (ACC/AHA). However, mortality rates remain high, and more effective treatments are still needed. This article reviews completed and ongoing studies on the efficacy of 2 potential ACS therapies— statins and antibiotics—that are currently under evaluation.