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COPYRIGHT 2005 International Medical News Group
The differences among the six statins available in the United States become sharpest when treating patients at very high risk for coronary artery disease. Moderate dosages of any statin will usually be adequate for lower-risk patients who do not need as large a reduction in serum level of LDL cholesterol.
But recently, goal LDL cholesterol for very-high-risk patients was set dramatically lower, based largely on the Pravastatin or Atorvastatin Evaluation and Infection Therapy--Thrombolysis in Myocardial Infarction 22 (PROVE IT-TIMI 22) trial in patients hospitalized for acute coronary syndrome (ACS). During 2 years of follow-up, outcomes that included death and nonfatal MI were significantly lower among those treated with an aggressive statin regimen of 80 mg of atorvastatin daily, whose serum LDL cholesterol dropped to an average lower than 70 mg/dL, compared with those treated with a moderate statin regimen of 40 mg of pravastatin daily (N. Engl. J. Med. 2004;350:1495-504). This finding was especially notable because the pravastatin regimen lowered LDL cholesterol to an average of 95 mg/dL, a target previously considered adequate for high-risk patients.
The study's impact was highlighted in July 2004 when the National Cholesterol Education Program revised the Adult Treatment Panel III guidelines for...
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