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IDEAL trial shows persistent protection with high-dose atorvastatin

By jeremyc | December 17, 2009

Source: MedWire News

Patients receiving intensive statin therapy should continue to do so even if they experience a cardiovascular (CV) event, say researchers who found the additional protective effect of a high versus standard statin dose persists through multiple events.

The findings emerge from a post-hoc analysis of the Incremental Decrease in End Points Through Aggressive Lipid Lowering (IDEAL) Trial, reported in theJournal of the American College of Cardiology.

Matti Tikkanen (Helsinki University Central Hospital, Finland) studied 8888 patients (80% men) with acute myocardial infarction (MI) who were randomly assigned to receive daily atorvastatin 80 mg or simvastatin 20–40 mg in IDEAL.

Of these patients, 2546 experienced a first on-treatment CV event, 1048 experienced a second event, 416 a third event, 192 a fourth event, and 93 a fifth event. The team used a broad definition of CV events, but reported events were predominantly coronary revascularization, nonfatal MI, and hospitalization for unstable angina.

Relative to patients receiving standard-dose simvastatin, those taking high-dose atorvastatin had a 17% reduction in the risk for a first CV event, and 24%, 19%, 24%, and 28% reductions in the risks for second, third, fourth, and fifth events, respectively.

The risk reductions were nonsignificant for fourth and fifth events, but the researchers say this is probably due to the relatively small number of patients experiencing this many events.

“This analysis provides new insights into the treatment of patients experiencing repeated occurrences of CV disease,” say Tikkanen et al.

“Often the question arises whether to continue high-dose statin therapy if such has been prescribed. The treating physician suspiciously considers the increasing possibility of drug–drug interactions, and the patient may feel that it might be prudent to use a smaller statin dose.

“Our results seem to indicate that, especially for such patients, intensive statin therapy is preferable to standard therapy.”

Topics: | Statins, Uncategorized |

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