Articles: anticholesteremic-agents-therapeutic-use.
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American heart journal · Sep 2004
Randomized Controlled Trial Multicenter Study Comparative Study Clinical TrialAchieving lipoprotein goals in patients at high risk with severe hypercholesterolemia: efficacy and safety of ezetimibe co-administered with atorvastatin.
Despite the efficacy of statins in lowering low-density lipoprotein cholesterol (LDL-C) levels, many patients who are at high risk for heart disease with hypercholesterolemia require additional LDL-C level reduction. The cholesterol absorption inhibitor, ezetimibe, has been shown to provide significant incremental reductions in LDL-C levels when co-administered with statins. This study was performed to compare the efficacy and safety of ezetimibe (10 mg) plus response-based atorvastatin titration versus response-based atorvastatin titration alone in the attainment of LDL-C goals in subjects who are at high risk for coronary heart disease (CHD) and are not at their LDL-C goal on the starting dose of atorvastatin. ⋯ The addition of ezetimibe to the starting dose of 10 mg/day of atorvastatin followed by response-based atorvastatin dose titration to a maximum of 40 mg/day provides a more effective means for reducing LDL-C levels in patients at high risk for CHD than continued doubling of atorvastatin as high as 80 mg/day alone.
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Use of statin therapy is a key first-line approach in preventing coronary heart disease events and stroke in people at increased risk of developing such complications. Ezetimibe (Ezetrol - MSD-Schering-Plough), the first licensed azetidinone drug, is being promoted as an adjunct to statin therapy to achieve greater reductions in blood cholesterol concentrations than occur with a statin alone. Here we review ezetimibe and consider its place in clinical practice.
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Cardiology in review · Sep 2004
ReviewCardiovascular pharmacotherapeutic considerations during pregnancy and lactation.
Table 2 summarizes the recommendations regarding the use of cardiovascular drugs during pregnancy and lactation.
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Randomized Controlled Trial Multicenter Study Clinical Trial
Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicentre randomised placebo-controlled trial.
Type 2 diabetes is associated with a substantially increased risk of cardiovascular disease, but the role of lipid-lowering therapy with statins for the primary prevention of cardiovascular disease in diabetes is inadequately defined. We aimed to assess the effectiveness of atorvastatin 10 mg daily for primary prevention of major cardiovascular events in patients with type 2 diabetes without high concentrations of LDL-cholesterol. ⋯ Atorvastatin 10 mg daily is safe and efficacious in reducing the risk of first cardiovascular disease events, including stroke, in patients with type 2 diabetes without high LDL-cholesterol. No justification is available for having a particular threshold level of LDL-cholesterol as the sole arbiter of which patients with type 2 diabetes should receive statins. The debate about whether all people with this disorder warrant statin treatment should now focus on whether any patients are at sufficiently low risk for this treatment to be withheld.
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Statins are a lipid-lowering medication. They are increasingly being used for the primary and secondary prevention of cardiovascular disease, as a growing body of research shows that they reduce mortality rates. Carol McLoughlin explains how they work, discusses contraindications, and offers advice on educating patients in their use.