[Secondary prevention in patients treated with coronary intervention]

Percutaneous coronary interventions have been growing rapidly in recent years for their favorable outcome. Coronary artery disease, however, is caused by a diffuse atherosclerotic process involving the whole coronary artery tree and commonly other vascular territories. In recent years, evidence has accumulated that several classes of secondary preventive drugs are clinically effective. The statins are the cornerstone for lipid-lowering therapy and reduce morbidity and mortality in patients with ACS and treated with interventional cardiology. The highest risk of a recurrent event in patients with acute coronary syndromes (ACS) occurs in the first month, with the rates of reported events ranging from 10-25%. More recent data from several trials show that statin therapy can reduce cardiovascular risk in unstable disease. In the MIRACL trial, early initiation of atorvastatin after an episode of unstable angina or non-Q-MI reduced events along the ensuing 16 weeks. The Third Report of the Expert Panel Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (ATP III) recommends that lipid lowering drug therapy be initiated at hospital discharge in patients with acute coronary syndromes and patients treated with percutaneous coronary interventions.