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Alternate-day versus daily atorvastatin in coronary artery disease: a randomized study

Osama Rifaie1, Ahmed Zahran, Wail Nammas

  • 1Department of Cardiology, Faculty of Medicine, Ain Shams University, Cairo-Egypt.

Anadolu Kardiyoloji Dergisi : AKD = the Anatolian Journal of Cardiology
|January 28, 2012
PubMed

Insights

Daily atorvastatin 10 mg is more effective than alternate-day dosing for maintaining low-density lipoprotein cholesterol (LDL-C) in coronary artery disease (CAD) patients. Both dosing regimens showed similar effects on high-sensitivity C-reactive protein (hs-CRP).

Area of Science:

  • Cardiology
  • Pharmacology
  • Clinical Trials

Background:

  • Coronary artery disease (CAD) management often involves statin therapy to control low-density lipoprotein cholesterol (LDL-C).
  • Optimizing statin dosing, such as atorvastatin, is crucial for achieving therapeutic goals and preventing cardiovascular events.
  • Understanding the efficacy of alternate-day versus daily dosing regimens is important for patient adherence and treatment effectiveness.

Purpose of the Study:

  • To compare the effects of alternate-day versus daily atorvastatin 10 mg on serum LDL-C and high-sensitivity C-reactive protein (hs-CRP) levels.
  • To evaluate the non-inferiority of alternate-day atorvastatin in patients with CAD who have achieved controlled LDL-C levels.
  • To assess the impact of different dosing frequencies on inflammatory markers in CAD patients.

Main Methods:

  • Prospective, randomized, single-blinded, two-armed study involving 60 patients with CAD.
  • Patients were randomized to receive atorvastatin 10 mg daily (Group A, n=30) or every other day (Group B, n=30).
  • Primary efficacy endpoints were changes in serum LDL-C and hs-CRP from baseline to 6-week follow-up.

Main Results:

  • At 6 weeks, Group A (daily dosing) had significantly lower LDL-C levels (88±21 mg/dl) compared to Group B (alternate-day dosing) (105±26 mg/dl, p=0.008).
  • The mean percent increase in LDL-C from baseline was significantly lower in the daily dosing group (1.5±0.2%) versus the alternate-day group (32.8±6.2%, p<0.0001).
  • No significant difference was observed in the mean percent change of hs-CRP between the two groups (p=0.108), and no side effects were reported.

Conclusions:

  • Alternate-day atorvastatin 10 mg is inferior to daily dosing for maintaining target LDL-C levels in CAD patients.
  • Daily atorvastatin is more effective in controlling LDL-C in patients with CAD.
  • Both dosing regimens demonstrated similar effects on hs-CRP levels, suggesting no significant impact on inflammation with alternate-day dosing.
Abstract

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