Rational Pharmacotherapy in Cardiology

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Results of large-scale studies carried out during last 10 years and devoted to the assessment of statines efficiency in prevention of ischemic heart disease (IHD), are analyzed. Decrease in risks of myocardial infarction, instable angina pectoris and mortality by 25-40%, ischemic stroke – by 25-30% (CARE, LIPID, WOSCOPS, AFCAPS/TexCAPS, HPS, ASCOT-LLA, CARDS) is demonstrated. Recommendations for statines prescription for primary and secondary prevention of cardiovascular diseases, including IHD and ischemic stroke, are significantly expanded. New goals in holesterol of low density lipoproteid (HLDL) reduction are discussed, aswell as problems of statin treatment safety. The choice of the drug must be based on clinical research data, considering efficiency and safety at long-term use, as well as possibilities of achieving new goal level of HLDL.

About the Author

Y. A. Karpov
Russian Cardiological Research and Production Complex of Roszdrav, Мoscow
Russian Federation


1. De Baker G, Ambrosioni E, Borch-Johnsen et al. European guidelines on cardiovascular prevention in clinical practice. Eur Heart J 2003; 24: 1601-1610.

2. Yusuf S, Giles WH, Croft JB, et al. Impact of multiple risk factor profiles on determining cardiovascular disease risk. Prev Med 1998; 27: 1-9.

3. Neaton JD, Blackburn H, Jacobs D et al. Serum cholesterol level and mortality findings for men screened in the Multiple Risk Factor Intervention Trial. Arch Intern Med 1992; 152: 1490-1500.

4. Abbot RD, Wilson PW, Kannel WB, et al. High density lipoprotein, total cholesterol screening and myocardial infarction. The Framigham Study. Arteriosclerosis 1988; 8: 207-211.

5. Scandinavian Simvastatin Survival Study Group: Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: The Scandinavian Simvastatin Survival Study. Lancet 1994: 344: 1383-1389.

6. Faergeman O. Evolution of statin therapy: an ongoing story. Eur Heart J Suppl 2004; 6 (Suppl A): A3-A7.

7. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) on Detection, Eval￾uation, and Treatment of High Blood Cholesterol in Adults (Adults Treatment Panel III). JAMA 2001; 285: 2486-2497.

8. Saks FM, Pfeffer MA, Moye LA, et al. The effects of pravastatin on coronary events after myocardial infarction in patients with average cholesterol levels. N Engl J Med 1996; 335: 1001-1009.

9. The long-term intervention with pravastatin in ischaemic disease (LIPID) study group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterl levels. N Engl J Med 1998; 339: 1349-1357.

10. Shepherd J, Cobbe SM, Ford I, et al. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. N Engl J Med 1995; 333: 1301-1307.

11. Downs JR, Clearfield M, Weis S, et al. Pimary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels. JAMA 1998; 279: 1615-1622.

12. Heart Protection Study Collaborative Group. MRC/BHF Heart Pro￾tection Study of cholesterol lowering with simvastatin in 20536 high-risk individuals: a randomized placebo-controlled trial. Lancet 2002; 360: 7-22.

13. Sever PS, Dahlof B, Poulter NR, et al for the ASCOT investigators. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial – Lipid Lowering Arm (ASCOT-LLA): a multicenter randomized controlled trial. Lancet 2003; 361: 1149-1158.

14. Colhoun HM, Betteridge DJ, Durrington PN, et al. Primary prevention of cardiovascular disease with atorvastatin in type 2 diabetes in the Collaborative Atorvastatin Diabetes Study (CARDS): multicen￾tre randomized placebo-controlled trial. Lancet 2004; 364: 685-696.

15. Guidelines Committee. 2003 European Society of Hypertension – European Society of Cardiology guidelines for the management of arterial hypertension. J Hypertension 2003; 21: 1011-1053.

16. The 7th report of the Joint National Committee on prevention, detection, evaluation, and treatment of high blood pressure. JAMA 2003; 289: 2560-2572.

17. Диагностика и коррекция нарушений липидного обмена с целью профилактики и лечения атеросклероза. Российские рекомендации. Кардиоваскулярная терапия и профилактика. 2004; 2 (приложение).

18. Athyros VG, Papageorgiou AA, Mercouris BR, et al. Treatment with atorvastatin to the National Cholesterol Educational Program goal versus “usual” care in secondary coronary heart disease prevention. GREACE study. Current Medical Research and Opinion 2002; 18: 220-228.

19. 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: 1495-1504.

20. Grundy SM, Cleeman JI, Merz NB, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation 2004; 110: 227-239.

21. Nissen SE, Tuzcu EM, Schoenhagen P, et al. Effect of intensive сompared with moderate lipid-lowering therapy on progression of coronary atherosclerosis. A randomized controlled trial. JAMA 2004; 291: 1071-1080.

22. La Rosa JC, Grundy SM, Waters DD, et al. Intensive lipid lowering with atorvastatin in patients with stable coronary disease. N Engl J Med 2005: 352: 1425-1435.

23. Grundy SM. The issue of statin safety. Where do we stand? Circulation 2005; 111:

24. Карпов ЮА, Сорокин ЕВ. Факторы риска ИБС: когда и как проводить коррекцию? Повышение роли статинов. РМЖ 2003; 11 (19): 1041-1045.

25. ILIB. Dyslipidemia and coronary heart disease. 3rd edition. New York 2003, 242 pp.

26. Pasternak RC, Smith SC Jr, Bairey-Merz CN, et al. ACC/AHA/NHLBI clinical advisory on the use and safety of statins. Circulation. 2002; 106: 1024 –1028.

27. Omar MA, Wilson JP. FDA adverse events on statin-associated rhabdomyolysis. Ann Pharmacother 2002; 36: 288-295.

28. Olsson A.G. Rosuvastatin in dyslipidaemia and coronary heart disease. Science Press. 2004. PP1-77

29. Jones PH, Davidson MH, Stein EA, et al and STELLAR Study Group. Comparison of the efficacy and safety of rosuvastatin versus atorvastatin, simvastatin, and pravastatin across doses (STELLAR Trial). Am J Cardiol 2003; 92: 152-160.

30. Alsheikh-Ali AA, Ambrose MS, Kuvin JT, et al. The safety of rosuvas￾tatin as used in clinical practice: a postmarketing analysis. Circulation 2005; 111.

31. Dunselman P, Hialmarson A, Kiekshus J, et al. Executive committee of the CORONA trial. The statin wars. Lancet 2003; 362: 1854.

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