The beneficial validity of hydroxy...

The beneficial validity of hydroxymethylglutaryl coenzyme A reductase inhibitors (statins) upon the progression of atherosclerosis has been noted in individual studies. This may be a "class effect" assuming equivalent improvement in lipid abnormalities. Hecht and Harman compared the weights of atorvastatin and simvastatin forward the progression of asymptomatic coronary artery disease (CAD) using serial electron beam tomography (EBT) to determine calcified plaque burden

by means of an observational technique that engrossed serial EBT evaluation, lipid-lowering agents, and dosing (as determined from treating physicians), 149 asymptomatic patients with no history of CAD who had positive evidence of atherosclerotic disease forward EBT evaluation were included in the consideration Aspirin use and tobacco cessation were commended to all patients, along with tight check of diabetes and hypertension. Patients were aggressively treated, resulting in optimal improvement in all lipid parameters. About 50 percent of patients in one as well as the other groups took niacin in addition to a statin.

After 14 month of treatment, comparison of the 46 participants taking simvastatin and the 103 participants taking atorvastatin demonstrated dramatic improvement in all lipid measurements with no significant post-treatment difference in progression rates of the calcium or book scores. Among untreated patients with asymptomatic atherosclerotic disease based onward EBT, the annual rate of progression of subclinical atherosclerosis ranged from 24 to 52 percent The enthralls in this study had an annual increase in EBT values of 75 percent in the simvastatin cluster and 10.8 percent in the atorvastatin dispose rates that were not significantly different. Calcium progression has been associated with a worse prognosis and an increase in adverse cardiac events

The authors decide that, among patients in these aggressively treated clusters the similar reduction in plaque progression rates in patients with asymptomatic CAD based upon EBT measurements demonstrates that this primary prevention weight is a "class effect." The relative general intents of the statins and niacin forward plaque development cannot be determined in this studious mood because of the high use of concomitant niacin.

Hecht H Harman SM Comparison of the tenors of atorvastatin versus simvastatin upon subclinical atherosclerosis in primary prevention as determined by the agency of electron beam tomography. Am J Cardiol January 1 2003;91:42-5

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