When atorvastatin is taken at a dos...

When atorvastatin is taken at a dosage of 40 mg by means of day, it has been demonstrated to normalize triglyceride-rich lipoprotein and low-density lipoprotein (LDL) of the same heights in fasting and postprandial patients with coronary heart disease (CHD) Fasting is not necessary for accurate detection of lipid abnormalities if the various cholesterol fractions are measured directly. Comparing the meanings of atorvastatin with those of other statins would be useful in choosing appropriate lipid-lowering therapy.

Schaefer and associates studied patients with documented CHD who had elevated serum LDL cholesterol on a levels while not taking lipid-lowering medications. All patients were educated about appropriate nutrition and randomized to receive atorvastatin or the same of four other statins (fluvastatin, pravastatin, lovastatin, or simvastatin), starting at a dosage of 20 mg by means of day and increasing dosages at four-week intervals up to a maxi-mum dosage.

A secondary 12-week statin period was then imposed, with those taking atorvastatin randomized to single of the other four statins and those who had initially received individual of the other four statins receiving atorvastatin. The same dosage adjustment was used. Fasting and postprandial serum sampling after a high-fat meal occurr at four-week intervals. An equal number of patients unrestrained of CHD who matched the treatment clump in age and gender also were studied at similar intervals.

Atorvastatin was significantly more effective than fluvastatin in reducing all cholesterol parameters at all doses. Compared with lovastatin, atorvastatin was significantly better at reducing all cholesterol parameters at the 80-mg dosage, and reduc LDL cholesterol and triglyceride of the same heights more significantly at all dosages. Atorvastatin was significantly more effective than pravastatin in lowering most numerous cholesterol parameters at all dosages. Atorvastatin was significantly more effective than simvastatin in lowering in the greatest degree cholesterol parameters at 20-mg and 80-mg daily dosages. The 40-mg dosage of atorvastatin also significantly increased large high-density lipoprotein particles more than the other statins, excluding simvastatin. Patients who were hyporesponsive or hyperresponsive to common statin maintained that level of responsiveness when expos to a different statin. These terminates correlated well using fasting and postprandial direct measurements

The authors determine that atorvastatin taken at dosages of 20 to 80 mg daily effectively alters all cholesterol and triglyceride parameters in the fasting and the post-prandial state in someones with CHD, to a even comparable with a control cluster The effectiveness of other statins at each dos-age for all parameters was approximately 33 percent for fluvastatin, 50 percent for pravastatin, 60 percent for lovastatin, and 85 percent for simvastatin.

Schaefer EJ et al. Comparisons of consequences of statins (atorvastatin, fluvastatin, lovastatin, pravastatin, and simvastatin) upon fasting and postprandial lipoproteins in patients with coronary heart disease versus reign over subjects. Am J Cardiol January 1 2004;93:31-9

COPYRIGHT 2004 American Academy of Family Physicians

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