Regular paperComparison of the effects of atorvastatin versus simvastatin on subclinical atherosclerosis in primary preventionas determined by electronbeam tomography
Section snippets
Subjects
One hundred forty-nine consecutive asymptomatic patients with EBT evidence for subclinical atherosclerosis, who were treated with atorvastatin or simvastatin alone or in combination with niacin and who underwent repeat EBT evaluation, comprised the patient population. This was an observational study, not a randomized trial; serial EBT evaluation and lipid-lowering agents and doses employed were chosen by the treating physicians based on practice patterns, and not according to criteria set by
Demographics (table 1)
There were no differences in risk factor distribution between the 2 groups. Men predominated and a family history of premature CAD was frequently noted (∼60%). Hypertension was considerably more common than smoking or diabetes. The atorvastatin dose was lower than that of simvastatin, reflecting their difference in potency. Similar percentages of patients were on niacin, in almost identical doses. The interscan interval was 1.2 years for atorvastatin and simvastatin patients.
Lipid and EBT values (table 1)
Before treatment,
Discussion
This study demonstrates that aggressive treatment with atorvastatin and simvastatin is associated with similar outcomes as measured by calcified plaque progression in a primary prevention population. This suggests that, in doses producing similar improvements in lipid profiles, they manifest a class effect with respect to progression of subclinical atherosclerosis, rather than a property unique to a particular drug.
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