Abstract
Hyperlipidemia is a disorder of lipoprotein metabolism, which includes a number of abnormalities such as hypercholesterolemia and hypertriglyceridemia. Recently World Health Organization (WHO) has declared that by 2020, 60% of cardiovascular cases will be of Indian origin. Treatment of hyperlipidemia with statins has become an integral part of management of vascular diseases. Indications of statins have been greatly extended over the last 5 years subsequent to the publication of many multicenter prospective trials. There are multiple statins available in the Indian market like atorvastatin, simvastatin, pravastatin, pitavastatin, fluvastatin, cerivastatin and rosuvastatin. Hypolipidemic effect of statins is due to inhibition of hydroxymethylglutaryl-CoA reductase (HMG-CoA) and decrease in LDL-C is due to up regulation of LDL receptor activity The objective of this study is to evaluate and compare the efficacy and safety of Rosuvastatin 20 mg and Atorvastation 20 mg among cardiac patients with hyperlipidemia in diabetics and non diabetics.
References
- Anderson KM, Odell PM, Wilson PW, Kannel WB. Cardiovascular risk profiles. Am Heart J 1991;121:293-8.
- Athyros VG, Papageorgiou AA, Hatzikonstandinou HA, Didangelos TP, Carina MV, Kranitsas DF et al. Safety and efficacy of long-term statin-fibrate combinations in patients with refractory familial combined hyperlipidemia. Am J Cardiol. 1997;80(5):608-13.
- Bakker-Arkema RG, Davidson MH, Goldstein RJ, Davignon J, Isaacsohn JL, Weiss SR et al. Efficacy and safety of a new HMG-CoA reductase inhibitor, atorvastatin, in patients with hypertriglyc-eridemia. JAMA. 1996;275(2):128-33.
- Bhopal Raj, Unwin N, White M, White M, Yallop J, Walker L, et al. Heterogeneity of coronary heart disease risk factors in Indian, Pakistani, Bangladeshi, and European origin populations: cross sectional study. Biomed Journal. 1999;319(7204):215-20.
- Brewer HB Jr. New features of the National Cholesterol Education Program Adult Treatment Panel III lipid-lowering guidelines. Clin Cardiol. 2003;26(S3):19-24.
- Brunzell JD, Failor RA. Diagnosis and Treatment of dyslipidemia. In: Dale DC, Federman DD. ACP MEDICINE, 3rd ed. New York: WebMD Inc; 2007. P. 729-47.
- Cannon CP, Braunwald E, McCabe CH, et al. Intensive versus moderate lipid lowering with statins after acute coronary syndromes. N Engl J Med 2004; 350:1495-1501.
- Ellen RL, McPherson R. Long-term efficacy and safety of fenofibrate and a statin in the treatment of combined hyperlipidemia. Am J Cardiol. 1998;81(4): 60-65B.
- Farnier M, Picard S. Diabetes: Statins, fibrates, or both. Curr Atheroscler Rep. 2001;3(1):19-28.
- Fiévet C, Staels B. Combination therapy of statins and fibrates in the management of cardiovascular risk. Current Opinion in Lipidology. 2009;20(6):505-11.
- Fleg JL, Mete M, Howard BV, Umans JG, Roman MJ, Ratner RE, et al. Effect of statins alone versus statins plus ezetimibe on carotid atherosclerosis in type 2 diabetes: The SANDS (Stop Atherosclerosis in Native Diabetics Study) trial. J Am Coll Cardiol 2008;52:2198-205.
- Guerin M, Lassel TS, Le Goff W, Farnier M, Chapman MJ. Action of atorvastatin in combined hyperlipidemia: Preferential reduction of cholesteryl ester transfer from HDL to VLDL1 particles. Arterioscler Thromb Vasc Biol. 2000;20(1):189-97.
- Haffner SM. Management of dyslipidemia in adults with diabetes. Diabetes Care. 2002;251:74-7.
- Josan K, Majundar SR, Mcalister FA. The efficacy and safety of intensive statin therapy: A meta analysis randomized trials. CMAJ 2008;176:576-83.
- Kinlay S, Schwartz GG, Olsson AG, Rifai N, Leslie SJ, Sasiela WJ, et al. High dose atorvastatin enhances the decline in inflammatory markers in patients with acute coronary syndromes. Circulation 2003;26:571-81
- Kiortisis DN, Millionis H, Bairaktari E, Elisaf MS. Efficacy of combination of atorvastatin and micronized fenofibrate in the treatment of severe mixed hyperlipidemia. Eur J Clin Pharmacol. 2000;56(9-10):631-35.
- Kumar T, Kapoor A. Premature coronary artery disease in North Indians: An angiography study of 1971 patients. Indian Heart J 2005;57:311-8.
- McKenney JM, Jones PH, Adamczyk MA, Cain VA, Bryzinski BS,BlasettoJW et al. Comparison of the efficacy of rosuvastatin versus atorvastatin, simvastatin, and pravastatin in achieving lipid goals: results from the STELLAR trial. Curr Med Res Opin. 2003;19(8):689-98.
- National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panal III). Final report. Circulation. 2002;106(25):3143-421.
- Ravi GR, Pradeepa R, Mohan V. Hyperlipidemia and coronary artery disease. An Update. Indian Heart J 2004;56:21-6.
- Talbert RL. Dyslipidemia. In: Diprio JT, editor. Pharmacotherapy-A Pathophysio-logical Approach. 8th ed. New York: McGraw-Hill; 2008. p. 365-88.
- Vega GL, Ma PT, Cater NB, Filipchuk N, Meguro S, Garcia AB et al. Effects of adding fenofibrate (200 mg/day) to simvastatin (10 mg/day) in patients withcombined hyperlipidemia and metabolic syndrome. Am J Cardiol. 2003;91(8): 956-60.
- Wierzbicki AS, Lumb PJ, Semra Y, Chik G, Christ ER, Crook MA. Atorvastatin compared with simvastatin based therapies in the management of severe familial hyperlipidemia. QJM 1999;92:387-94.
Corresponding Author
Dr Manish Pokra
DOI: https://dx.doi.org/10.18535/jmscr/v6i7.49
