Therapeutic change of HMG-CoA reductase inhibitors in patients with coronary artery disease

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Abstract

Study Objective. To evaluate short-term outcomes when atorvastatin was substituted for pravastatin or simvastatin in patients with coronary artery disease. Design. Open-label, fixed-dosage, one-way crossover from pravastatin and simvastatin to atorvastatin. Setting. University-affiliated hospital and outpatient clinics. Patients. Eighty patients with coronary artery disease with a minimum baseline low-density lipoprotein (LDL) above 130 mg/dl: 20 were treated with pravastatin 20 mg/day, 20 with pravastatin 40 mg/day, 20 with simvastatin 20 mg/day, and 20 with simvastatin 40 mg/day for a minimum of 6 months, with a prescription refill rate of 80% or greater. Intervention. Before crossover, patients had a fasting lipid profile determined and were questioned about side effects of pravastatin and simvastatin. All patients were switched to atorvastatin 10 mg/day. After 12 weeks of atorvastatin therapy, a repeat fasting lipid profile was obtained and patients were questioned about side effects with the drug. Measurements and Main Results. Baseline demographic and clinical characteristics of the treatment groups were not significantly different with the exception of a lower baseline LDL in patients receiving pravastatin 20 mg/day. Baseline LDL values were as follows: pravastatin 20 mg/day, 158 ± 26 mg/dl; pravastatin 40 mg/day, 176 ± 22 mg/dl; simvastatin 20 mg/day, 177 ± 27 mg/dl; and simvastatin 40 mg/day, 177 ± 27 mg/dl. Reductions in LDL after treatment with pravastatin or simvastatin were as follows: pravastatin 20 mg/day, 22%; pravastatin 40 mg/day, 32%; simvastatin 20 mg/day, 33%; and simvastatin 40 mg/day, 38%. Patients achieving LDL goal with initial therapy were as follows: pravastatin 20 mg/day, 5%; pravastatin 40 mg/day, 5%; simvastatin 20 mg/day, 20%; and simvastatin 40 mg/day, 30%. After the switch to atorvastatin 10 mg/day, reductions in LDL were as follows: pravastatin 20 mg/day, 39% (p

Original languageEnglish
Pages (from-to)410-415
Number of pages6
JournalPharmacotherapy
Volume21
Issue number4
StatePublished - 2001

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Pravastatin
Simvastatin
Coronary Artery Disease
LDL Lipoproteins
Therapeutics
Fasting
Hospital Outpatient Clinics
Lipids
Drug-Related Side Effects and Adverse Reactions

All Science Journal Classification (ASJC) codes

  • Pharmacology (medical)
  • Pharmacology, Toxicology and Pharmaceutics(all)

Cite this

Therapeutic change of HMG-CoA reductase inhibitors in patients with coronary artery disease. / Hilleman, Daniel E.; Wurdeman, R. L.; Lenz, Thomas L.

In: Pharmacotherapy, Vol. 21, No. 4, 2001, p. 410-415.

Research output: Contribution to journalArticle

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abstract = "Study Objective. To evaluate short-term outcomes when atorvastatin was substituted for pravastatin or simvastatin in patients with coronary artery disease. Design. Open-label, fixed-dosage, one-way crossover from pravastatin and simvastatin to atorvastatin. Setting. University-affiliated hospital and outpatient clinics. Patients. Eighty patients with coronary artery disease with a minimum baseline low-density lipoprotein (LDL) above 130 mg/dl: 20 were treated with pravastatin 20 mg/day, 20 with pravastatin 40 mg/day, 20 with simvastatin 20 mg/day, and 20 with simvastatin 40 mg/day for a minimum of 6 months, with a prescription refill rate of 80{\%} or greater. Intervention. Before crossover, patients had a fasting lipid profile determined and were questioned about side effects of pravastatin and simvastatin. All patients were switched to atorvastatin 10 mg/day. After 12 weeks of atorvastatin therapy, a repeat fasting lipid profile was obtained and patients were questioned about side effects with the drug. Measurements and Main Results. Baseline demographic and clinical characteristics of the treatment groups were not significantly different with the exception of a lower baseline LDL in patients receiving pravastatin 20 mg/day. Baseline LDL values were as follows: pravastatin 20 mg/day, 158 ± 26 mg/dl; pravastatin 40 mg/day, 176 ± 22 mg/dl; simvastatin 20 mg/day, 177 ± 27 mg/dl; and simvastatin 40 mg/day, 177 ± 27 mg/dl. Reductions in LDL after treatment with pravastatin or simvastatin were as follows: pravastatin 20 mg/day, 22{\%}; pravastatin 40 mg/day, 32{\%}; simvastatin 20 mg/day, 33{\%}; and simvastatin 40 mg/day, 38{\%}. Patients achieving LDL goal with initial therapy were as follows: pravastatin 20 mg/day, 5{\%}; pravastatin 40 mg/day, 5{\%}; simvastatin 20 mg/day, 20{\%}; and simvastatin 40 mg/day, 30{\%}. After the switch to atorvastatin 10 mg/day, reductions in LDL were as follows: pravastatin 20 mg/day, 39{\%} (p",
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AU - Lenz, Thomas L.

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N2 - Study Objective. To evaluate short-term outcomes when atorvastatin was substituted for pravastatin or simvastatin in patients with coronary artery disease. Design. Open-label, fixed-dosage, one-way crossover from pravastatin and simvastatin to atorvastatin. Setting. University-affiliated hospital and outpatient clinics. Patients. Eighty patients with coronary artery disease with a minimum baseline low-density lipoprotein (LDL) above 130 mg/dl: 20 were treated with pravastatin 20 mg/day, 20 with pravastatin 40 mg/day, 20 with simvastatin 20 mg/day, and 20 with simvastatin 40 mg/day for a minimum of 6 months, with a prescription refill rate of 80% or greater. Intervention. Before crossover, patients had a fasting lipid profile determined and were questioned about side effects of pravastatin and simvastatin. All patients were switched to atorvastatin 10 mg/day. After 12 weeks of atorvastatin therapy, a repeat fasting lipid profile was obtained and patients were questioned about side effects with the drug. Measurements and Main Results. Baseline demographic and clinical characteristics of the treatment groups were not significantly different with the exception of a lower baseline LDL in patients receiving pravastatin 20 mg/day. Baseline LDL values were as follows: pravastatin 20 mg/day, 158 ± 26 mg/dl; pravastatin 40 mg/day, 176 ± 22 mg/dl; simvastatin 20 mg/day, 177 ± 27 mg/dl; and simvastatin 40 mg/day, 177 ± 27 mg/dl. Reductions in LDL after treatment with pravastatin or simvastatin were as follows: pravastatin 20 mg/day, 22%; pravastatin 40 mg/day, 32%; simvastatin 20 mg/day, 33%; and simvastatin 40 mg/day, 38%. Patients achieving LDL goal with initial therapy were as follows: pravastatin 20 mg/day, 5%; pravastatin 40 mg/day, 5%; simvastatin 20 mg/day, 20%; and simvastatin 40 mg/day, 30%. After the switch to atorvastatin 10 mg/day, reductions in LDL were as follows: pravastatin 20 mg/day, 39% (p

AB - Study Objective. To evaluate short-term outcomes when atorvastatin was substituted for pravastatin or simvastatin in patients with coronary artery disease. Design. Open-label, fixed-dosage, one-way crossover from pravastatin and simvastatin to atorvastatin. Setting. University-affiliated hospital and outpatient clinics. Patients. Eighty patients with coronary artery disease with a minimum baseline low-density lipoprotein (LDL) above 130 mg/dl: 20 were treated with pravastatin 20 mg/day, 20 with pravastatin 40 mg/day, 20 with simvastatin 20 mg/day, and 20 with simvastatin 40 mg/day for a minimum of 6 months, with a prescription refill rate of 80% or greater. Intervention. Before crossover, patients had a fasting lipid profile determined and were questioned about side effects of pravastatin and simvastatin. All patients were switched to atorvastatin 10 mg/day. After 12 weeks of atorvastatin therapy, a repeat fasting lipid profile was obtained and patients were questioned about side effects with the drug. Measurements and Main Results. Baseline demographic and clinical characteristics of the treatment groups were not significantly different with the exception of a lower baseline LDL in patients receiving pravastatin 20 mg/day. Baseline LDL values were as follows: pravastatin 20 mg/day, 158 ± 26 mg/dl; pravastatin 40 mg/day, 176 ± 22 mg/dl; simvastatin 20 mg/day, 177 ± 27 mg/dl; and simvastatin 40 mg/day, 177 ± 27 mg/dl. Reductions in LDL after treatment with pravastatin or simvastatin were as follows: pravastatin 20 mg/day, 22%; pravastatin 40 mg/day, 32%; simvastatin 20 mg/day, 33%; and simvastatin 40 mg/day, 38%. Patients achieving LDL goal with initial therapy were as follows: pravastatin 20 mg/day, 5%; pravastatin 40 mg/day, 5%; simvastatin 20 mg/day, 20%; and simvastatin 40 mg/day, 30%. After the switch to atorvastatin 10 mg/day, reductions in LDL were as follows: pravastatin 20 mg/day, 39% (p

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