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Clinical outcomes of high‐intensity doses of atorvastatin in patients with acute coronary syndrome: A retrospective cohort study using real‐world data
Author(s) -
Rahhal Alaa,
Khir Fadi,
Aljundi Amer Hussien,
AlAhmad Yaser,
Alzaeem Hakam,
Habra Masa,
AlShekh Israa,
Mahfouz Ahmed,
Awaisu Ahmed,
AlYafei Sumaya,
Arabi Abdul Rahman
Publication year - 2021
Publication title -
british journal of clinical pharmacology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.216
H-Index - 146
eISSN - 1365-2125
pISSN - 0306-5251
DOI - 10.1111/bcp.14613
Subject(s) - atorvastatin , medicine , hazard ratio , acute coronary syndrome , myocardial infarction , confidence interval , proportional hazards model , retrospective cohort study , clinical endpoint , cohort study , randomized controlled trial
Aims To compare the effectiveness and safety of 2 high‐intensity atorvastatin doses (40 mg vs 80 mg) among acute coronary syndrome (ACS) patients. Methods This retrospective observational cohort study using real‐world data included patients admitted with ACS to the Heart Hospital in Qatar between 1 January 2017 and 31 December 2018. The primary endpoint was a composite of cardiovascular disease‐associated death, nonfatal ACS and nonfatal stroke. Cox proportional hazard regression analysis was used to determine the association between the 2 high‐intensity atorvastatin dosing regimens and the primary outcome at 1 month and 12 months postdischarge. Results Of the 626 patients included in the analyses, 475 (75.9%) received atorvastatin 40 mg, while 151 (24.1%) received atorvastatin 80 mg following ACS. Most of the patients were Asian (73%), male (97%) with a mean age of 50 years and presented with ST‐elevation myocardial infarction (60%). The incidence of the primary effectiveness outcome did not differ between the atorvastatin 40‐and 80‐mg groups at 1 month (0.8 vs 1.3%; adjusted hazard ratio = 0.59, 95% confidence interval 0.04–8.13, P = .690) and at 12 months (3.2 vs 4%; adjusted hazard ratio = 0.57, 95% confidence interval 0.18–1.80, P = .340). Similarly, the use of the 2 doses of atorvastatin resulted in comparable safety outcomes, including liver toxicity, myopathy and rhabdomyolysis with an event rate of <1% in both groups. Conclusion The use of atorvastatin 40 mg in comparison to atorvastatin 80 mg in patients with ACS resulted in similar cardiovascular effectiveness and safety outcomes.