The results of a new study announced showed that, compared to atorvastatin 20-40 mg therapy, intensive atorvastatin 80 mg therapy significantly reduced the risk of major cardiovascular events, including cardiovascular related death and non-fatal heart attacks, by 40 percent in patients with end-stage coronary artery disease who have already suffered an acute heart attack. The results were presented at the 2008 European Society of Cardiology (ESC) Congress.

The study included 290 patients who were admitted to the hospital for acute heart attack. The primary endpoint of the study was defined as the combination of cardiovascular related death, non-fatal acute heart attack and disabling stroke.

"Patients with end-stage coronary artery disease who have already suffered a first heart attack have a very high risk of either dying or suffering another heart attack or stroke. These patients are particularly difficult to treat, as their coronary arteries are so extensively damaged that they cannot be treated with surgery or angioplasty," said Professor Furio Colivicchi, study author and Director, Clinical Quality Management Unit at the Cardiovascular Department, San Filippo Neri Hospital, Rome, Italy. "Based on these results, high-dose atorvastatin therapy provides physicians with a safe yet significantly more effective treatment option for these patients."

Clinical Implications of Switching from Intensive to Moderate Statin Therapy

Also presented at the 2008 ESC Congress, an observational study of more than 1,300 patients who have experienced acute coronary syndrome showed that, within one year of release from the hospital, those who switched from intensive atorvastatin 80 mg therapy to either another statin or lower dose atorvastatin were twice as likely to die or suffer a non-fatal heart attack as patients who remained on atorvastatin 80 mg.

"This additional finding suggests that patient care urgently needs to be improved during the transition from a hospital setting, where intensive atorvastatin therapy is initially prescribed, to outpatient primary care settings, where switching may be encouraged," Dr Colivicchi further commented. "The findings from both studies not only highlight the importance of utilizing intensive lipid-lowering therapy in high-risk patients but also reveal that switching these patients to lower statin doses can be detrimental to their overall recovery."

ESC Congress 2008