Intensive Statin Therapy A Sea Change

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• Intensive Statin Therapy A Sea Change
• in Cardiovascular Prevention (Editorial)
• Eric J. Topol, M.D.

Comparison of Intensive and Moderate Lipid
Lowering with Statins after Acute Coronary
Syndromes Christopher P. Cannon, M.D. et. al
N Engl J Med 35015 www.nejm.org april 8, 2004
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Managing Atherosclerotic Vascular Disease

• Statin drugs have already surpassed all other
  classes of medicines in reducing incidence of
  major adverse outcomes of death, heart attack,
  and stroke.

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Comparing 2 statin drugs

• Atarvastatin 80 mg.
• Pravastatin 40 mg.
• Equivalent doses
• Trial was designed to demonstrate non-inferiority
  of pravastatin. Instead, it showed ataravastatin
  to be superior.
• Not only did ataravastatin lower cholesterol more
  (and faster), but it lowered death rate by 16
• Study was stopped early.

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Sample Properties
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Editors Comments

• Based on current national guidelines, 36 million
  people in U.S. should be taking a statin, but
  only 11 million are.
• Worldwide the discrepancies are 250 million v. 25
  million.
• 80 mg. dose costs 1,400 per year.
• Statin drugs already account for 12.5 billion in
  expenditures per year.