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Updated: Jun 12, 2026
09:15
Differential Effects of Lipid-lowering Drugs in Modulating Morphology of Cholesterol Particles
Published on: November 10, 2017
Potent anti-ischaemic effects of statins in chronic stable angina: incremental benefit beyond lipid lowering?
John E Deanfield1, Phillipe Sellier, Erik Thaulow
1Great Ormond Street Hospital, University College London, London, UK. j.deanfield@ich.ucl.ac.uk
European Heart Journal
|May 25, 2010
Summary
Atorvastatin demonstrated anti-ischaemic effects comparable to amlodipine in patients with coronary artery disease. This study found no additional benefit when combining atorvastatin with amlodipine for reducing transient myocardial ischaemia.
Area of Science:
- Cardiology
- Pharmacology
Background:
- The DoUble-blind Atorvastatin AmLodipine (DUAAL) trial investigated the vascular benefits of atorvastatin beyond LDL cholesterol reduction in coronary artery disease (CAD) patients.
- It assessed atorvastatin's efficacy alone and in combination with amlodipine, a traditional anti-anginal therapy.
Purpose of the Study:
- To determine if atorvastatin reduces ischaemia through vascular mechanisms independent of lipid-lowering.
- To compare the anti-ischaemic efficacy of amlodipine, atorvastatin, and their combination in CAD patients.
Main Methods:
- A randomized, double-blind, parallel-group, multicountry trial involving 311 patients with stable angina and CAD.
- Patients received amlodipine, atorvastatin, or amlodipine + atorvastatin for 24 weeks after a 2-week run-in period.
- Efficacy was assessed by changes in transient myocardial ischaemia (TMI), exercise capacity, angina symptoms, and inflammatory markers.
Main Results:
- Both amlodipine and atorvastatin significantly reduced TMI, with no additional benefit from the combination therapy.
- Over 50% of patients in all groups became TMI-free, experiencing reduced angina and nitroglycerin use.
- Atorvastatin significantly decreased high-sensitivity C-reactive protein by 40%, while amlodipine did not.
Conclusions:
- Atorvastatin is a potent anti-ischaemic agent, comparable in efficacy to amlodipine.
- Further research into combination therapies for CAD is warranted.
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