Atorvastatin and simvastatin in clinical management of high-risk patients
Abstract
Aim. То assess the use of average therapeutic doses of atorvastatin and simvastatin (Torvacard and Simvacard) in real-world clinical management of high-risk patients.
Material and methods. The study included 347 doctors from 30 Russian cities and 1163 high-risk patients randomised into two groups: Torvacard, 20 mg/day (n=672) and Simvacard, 20 mg/day (n=491). Ah patients completed a standard questionnaire, underwent anthropometry and measurement of blood pressure, heart rate, total cholesterol (TCH), low and high-density lipoprotein CH(LDL-CH, HDL-CH), triglycerides (TG), as well as liver enzymes and creatine phosphokinase activity as safety markers. The study lasted for 3 months. Lipid-lowering therapy was regarded as effective if target TDT-CH levels (<2,5 mmol/1) were achieved.
Results. TCH and LDL-CH levels reduced by 31,2% and 38,8%, respectively, in Torvacard group, and by 21,4% and 21,5% in Simvacard group (p<0,001). Both medications significantly reduced TG levels — by 21,1% and 15,9%, respectively. In Torvacard group, more than 50% of the patients achieved target LDL-CH levels, and in Simvacard group — only 19,6% (p<0,0001). In total, 18 adverse events were registered: 10 (1,5%) and 8 (1,5%) in Torvacard and Simvacard groups, respectively (p=0,9).
Conclusion. Early administration of a higher Torvacard dose (20 mg) was much more effective in achieving target lipid levels in high-risk patients, without increasing adverse event risk. Clinicians should remember about the positive correlation between statin dose and adverse effect risk, monitoring chnical and laboratory safety parameters.
About the Authors
S. A. Shalnova
State Research Centre for Preventive Medicine
Russian Federation
Russian Federation
Moscow
A. D. Deev
State Research Centre for Preventive Medicine
Russian Federation
Russian Federation
Moscow
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For citations:
Shalnova S.A., Deev A.D. Atorvastatin and simvastatin in clinical management of high-risk patients. Cardiovascular Therapy and Prevention. 2009;8(1):62-66. (In Russ.)
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