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Review

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Statins for Secondary Prevention of Cardiovascular Disease: The Right Dose

Spector R.a · Snapinn S.M.b

Author affiliations

aRobert Wood Johnson Medical School, Piscataway, N.J., and bGlobal Biostatistics and Epidemiology, Amgen, Inc., Thousand Oaks, Calif., USA

Corresponding Author

Reynold Spector, MD

105 Stone Hill Road

Colts Neck, NJ 07722 (USA)

Tel./Fax +1 732 780 5762

E-Mail mspec007@verizon.net

Related Articles for ""

Pharmacology 2011;87:63–69

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Abstract

Since the publication of the 4S trial in 1994, there has emerged a consensus that statins save lives and decrease myocardial infarctions and strokes in coronary artery disease (CAD) patients irrespective of baseline serum cholesterol. However, there is controversy over the correct dose and the utility of the treatment-to-goal (cholesterol, low-density lipoprotein) approach. To answer remaining questions about the optimal statin dose in CAD patients, we have performed simple and meta-analyses of 3 large long-term (approx. 5 years) dose-clinical response studies (TNT, IDEAL, and SEARCH) and compared the results with older data including long-term safety data. The results show that raising the dose of simvastatin or atorvastatin to 80 mg confers no mortality advantage, an increase in adverse reactions and only a slight decrease in myocardial infarctions and stroke versus a lower dose. These results suggest a cost-effective approach of a single safe dose (40 mg of inexpensive generic simvastatin or atorvastatin) for almost all CAD patients and makes treatment-to-goal and cholesterol monitoring (except to check for medication compliance) unnecessary; moreover, it is likely to improve the weakness in statin use – medication compliance.

© 2011 S. Karger AG, Basel


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Article / Publication Details

First-Page Preview
Abstract of Review

Received: August 20, 2010
Accepted: November 19, 2010
Published online: January 11, 2011
Issue release date: February 2011

Number of Print Pages: 7
Number of Figures: 0
Number of Tables: 4

ISSN: 0031-7012 (Print)
eISSN: 1423-0313 (Online)

For additional information: https://www.karger.com/PHA


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