Comparison between 20 mg versus 40 mg dose of atorvastatin among dyslipidemic patients associated with diabetes or coronary artery disease: a randomized clinical trial

Treatment of dyslipidemia among patients with diabetes or vascular disease improves patients’ outcome. Statins are the most popular drugs used, but there is controversy on the optimum dose. In this study we aim to compare atorvastatin 20 mg versus atorvastatin 40 mg on lipid profile. Fifty five newly diagnosed patients suffering from dyslipidemia associated with diabetes or coronary artery disease aged(20–75) years with fasting total cholesterol concentrations (200 mg/L) or more and Triglyceride level 250 mg/L were randomly assigned to atorvastatin 20 mg or atorvastatin 40 mg. The lipid profile was taken at the start of study (baseline data) and after 6 months (final data). We planned follow-up for an average of 6 months. Data were analyzed using SPSS version 20. For statistical analysis the paired sample t test and the independent sample t test were used.Treatment was completed for 6 months. There were improvement in the lipid profile in both doses (p=0.05). No significant differences were found in lipid profile between the two groups except in cholesterol level (P-value 0,01) while regarding the remaining variables(TG, HDL, LDL, F.B.S,SGOT,SGPT) P-values were not statistical significantly different(0.776, 0.201, 0.383, 0.256, 0.832, 0.449 respectively). Atorvastatin lowered LDL by 23% as well as improved HDL by 6,3%. The reductions of lipid profile with atorvastatin were large with both doses (20 and 40 mg). Furthermore there is no difference between the two doses. Therefore it is recommended to start with the lower dose

___

1. Laurence L. Brunton, PhD, John S Lazo, PhD, Keith L. Parker, MD, PhD Goodman & Gilman's The Pharmacological Basis of Therapeutics - 12th edition. 2011.

2. Richard Finkel Pharm. D. Michelle A. Clark Ph.D. Lippincott's Illustrated Reviews: Pharmacology, 4th edition. Copyright Lippincott Williams & Wilkins. 2009.

3. Moray longmore, Ian Wilkinson, Tomturmezei, Cheek Ay Cheung oxford hand book of clinical medicine 7th edition 2014.

4. Dobler CC, Wong KK, Marks GB. Associations between statins and COPD: a systematic review. BMC Pulm Med. 2009;12(9):32.

5. Janda S, Park K, FitzGerald JM, Etminan M, Swiston J. Statins in COPD: a systematic review. Chest. 2009;136(3):734-43.

6. Hurst JR., Hagan G, MD; Wedzicha JA. Mechanism of StatinAssociated Mortality Reduction in COPD. Chest. 2007;132(4):1409- 10.

7. Young RP, Hopkins RJ. Possible role of statins in COPD-related pulmonary hypertension. Chest. 2010;137(5):1250-1. 8. Josan K1

, McAlister FA. Cholesterol lowering for secondary prevention: what statin dose should we use? Vasc Health Risk Manag. 2007;3(5):615–27.

9. Kosmas I. Paraskevas, Dimitri P, Mikhailidis, MD,b Frank JV, FACSc , Athens, Greece; London, United Kingdom; and New York, NY Optimal statin type and dosage for vascular patients. 2011;53(3):837-44.

10. Friend AS, Kamalesh M, Schellhase E, Eckert GJ, Evans TS. Effect of time to titration to maximum dose of statins on cardiovascular outcomes: a retrospective analysis in high-risk patients. Am J Cardiovasc Drugs. 2009;9(2):103-7.

11. Law MR, Wald NJ, Rudnicka AR. Quantifying effect of statins on low density lipoprotein cholesterol, ischaemic heart disease, and stroke: systematic review and meta-analysis. BMJ. 2003;326(7404):1423.

12. Navi BB, Segal AZ. The role of cholesterol and statins in stroke. Curr Cardiol Rep. 2009;11(1):4-11.

13. Turner AM, Jowett NI. The role of statin therapy in preventing recurrent stroke. Nurs Times. 2006;102(38):25-6.

14. Martin JH, Mangiafico S, Kelly DJ. Role of statins in diabetes complications. Curr Diabetes Rev. 2009;5(3):165-170.

15. Preiss D1, Seshasai SR, Welsh P, Murphy SA, Ho JE, Waters DD, DeMicco DA, Barter P, Cannon CP, Sabatine MS, Braunwald E, Kastelein JJ, de Lemos JA, Blazing MA, Pedersen TR, Tikkanen MJ, Sattar N, Ray KK. Risk of incident diabetes with intensive-dose compared with moderate-dose statin therapy: a meta analysis. JAMA. 2011;305(24):2556-64.

16. Culver AL, Ockene IS, Balasubramanian R, Olendzki BC, Sepavich DM, Wactawski-Wende J, Manson JE, Qiao Y, Liu S, Merriam PA, Rahilly-Tierny C, Thomas F, Berger JS, Ockene JK, Curb JD, Ma Y. Statin use and risk of diabetes mellitus in postmenopausal women in the Women's Health Initiative. Arch Intern Med. 2012;172(2)144-52.

17. Delahoy PJ, Magliano DJ, Webb K, Grobler M, Liew D. The relationship between reduction in low-density lipoprotein cholesterol by statins and reduction in risk of cardiovascular outcomes: an updated meta-analysis. Clin Ther. 2009;31(2):236–44.

18. Mills EJ, Rachlis B, Wu P, Devereaux PJ, Arora P, Perri D. Primary prevention of cardiovascular mortality and events with statin treatments: a network meta-analysis involving more than 65,000 patients. J Am Coll Cardiol. 2008;52(22):1769-81.

19. Toth PP. The role of statins in managing diabetic dyslipidemia J Fam Pract. 2010;59(5 Suppl)S33-9.

20. Buemi M, Nostro L, Crascì E, Barillà A, Cosentini V, Aloisi C, Sofi T, Campo S, Frisina N. Statins in nephrotic syndrome: a new weapon against tissue injury. Med Res Rev. 2005;25(6):587-609.

21. Resh M, Mahmoodi BK, Navis GJ, Veeger NJ, Lijfering WM. Statin use in patients with nephrotic syndrome is associated with a lower risk of venous thromboembolism. Thromb Res. 2011;127(5):395-9.
Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: 4
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )
Sayıdaki Diğer Makaleler

Assessment of satisfaction and anxiety levels of the patients who had cesarean section with general and spinal anesthesia

Basak ALTİPARMAK, Sezen Bozkurt KOSEOGLU

Seroprevalence of Hepatitis A Virus in Inonu University Medical Faculty Hospital, 2015

YÜCEL DUMAN, MEHMET SAİT TEKEREKOĞLU, SELMA AY, Ayfer SERİNDAĞ

An evaluation of the indications, complications and results of patients with percutaneous endoscopic gastrostomy

Oğuzhan YILDIRIM, Yüksel SEÇKİN, Yılmaz BİLGİÇ, Melih KARINCAOĞLU, Murat ALADAĞ

The value of indirect serum markers in predicting severity of fibrosis in treatment naive patients with non-cirrhotic hepatitis C virus infection

Murat AFYON, CUMHUR ARTUK, Ercan YENİLMEZ, Berksan ŞİMŞEK, Ayper KAYA

Assessment of physicians' knowledge in transfusion medicine in eastern part of Turkey

Soner Sertan KARA, Duygu KARA, Ali FETTAH, Gokce Pinar REİS, Alev Cansu CERTEL

Effects of the transcatheter closure of atrial septal defect on electrocardiographic and echocardiographic parameters six months after the closure

Halil ATAŞ, Mehmet CANSEL, Ertuğrul KURTOĞLU, Hasan PEKDEMİR, Ramazan ÖZDEMİR

Comparing mycobacterium tuberculosis complex susceptibility methods, a developing country’s experience

Yasemin Ay ALTINTOP, Duygu PERÇİN

One year follow-up cardiovascular outcomes of coraxel brand paclitaxel eluting stents: a single center experience

Fatih LEVENT, Sadık Volkan EMREN, NİHAN KAHYA EREN, Cem NAZLI, Hamza DUYGU

Lymph node evaluation and survival after resection of colorectal cancer

Lütfi SOYLU, Oğuz Uğur AYDIN, Nedim ÇEKMEN, Fuat ATALAY

The menace of the green monster on the postoperative diabetic foot wounds

Amit Kumar C JAİN