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Example sentences for: miracl
How can you use “miracl” in a sentence? Here are some example sentences to help you improve your vocabulary:
The efficacy and safety findings from MIRACL were unique for a number of reasons.
HMG CoA = 3-Hydroxy-3-methylgluatryl coenzyme A; MIRACL = Myocardial Ischemia Reduction with Aggressive Cholesterol Lowering; LDL = low density lipoprotein; RR = relative risk; CI = confidence interval; HDL = high density lipoprotein; PTCA = percutaneous transluminal coronary angioplasty; CABG = coronary artery bypass graft; ECG = electrocardiogram; A-2-Z = Aggrastat to Zocor; ACS = acute coronary syndrome; PROVE IT = Pravastatin or Atorvastatin Evaluation and Infection Therapy.
Even if these findings are not confirmed after further study, one could still make a compelling argument that lipid-lowering therapy (barring contraindications) should be initiated early and universally in patients who present with an acute coronary syndrome: First, the long-term safety and effectiveness of statins for the secondary prevention of stable coronary disease is well-established [ 1 2 3 ] ; Second, as evidenced by MIRACL, these agents are safe when initiated at the time of hospitalization for an acute coronary syndrome; Third, the in-hospital initiation of lipid-lowering therapy appears to promote greater long-term utilization of these agents [ 18 19 20 21 ] . Finally, although lipid levels may be unreliable in the setting of an acute coronary syndrome (excepting total :HDL and LDL:HDL cholesterol ratios [ 22 ] ) the overwhelming majority of patients with coronary disease will ultimately require both pharmacologic and non-pharmacologic lipid-lowering interventions to attain recommended cholesterol targets [ 23 24 25 ] ; newer guidelines are even more stringent [ 26 ] . Furthermore, data from the recently presented Heart Protection Study suggest that clinical benefits may accrue independent of baseline cholesterol level [ 4 ] . Thus, to withhold lipid-lowering therapy from patients who present with an acute coronary syndrome would be to accept the status quo, and to date our efforts at cholesterol lowering in the secondary prevention setting have been dismal [ 27 28 ] .
MIRACL enrolled 3,086 patients within 24-96 hours (mean 63 hours) of admission for unstable angina or a non-Q-wave myocardial infarction and randomized them to 16 weeks of atorvastatin 80 mg or placebo once daily [ 5 ] . The major exclusion criteria were: total cholesterol level greater than 270 mg/dL; Q-wave myocardial infarction on admission or during the previous month; and, coronary revascularization in the months before admission, during the index hospitalization or anticipated following hospital discharge.
Although MIRACL and the two aforementioned cohort studies suggest that lipid-lowering agents exert short-term clinical benefits when initiated soon after an acute coronary syndrome, this remains an open question.
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