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[Efficacy and safety of atorvastatin in major cardiovascular events: Meta-analysis]
Víctor Eder Villegas-Quintero1, Rodolfo Rivas-Ruíz1, Alexis Alejandro García-Rivero1
1Instituto Mexicano del Seguro Social, Coordinación de Investigación en Salud, Centro de Adiestramiento en investigación Clínica. Ciudad de México, México.
Insights
High-dose atorvastatin (80 mg) effectively reduces Major Cardiovascular Events (MACE) in secondary prevention. While associated with some adverse events, they are comparable to lower doses, making it a valuable treatment option.
Area of Science:
- Cardiology
- Pharmacology
- Clinical Trials
Context:
- Dyslipidemia management often involves statins.
- High-dose atorvastatin's role in secondary cardiovascular event prevention requires further elucidation.
- Understanding the efficacy and safety profile of 80 mg atorvastatin is crucial for clinical decision-making.
Purpose:
- To systematically evaluate the impact of high-dose atorvastatin (80 mg) on the secondary prevention of Major Cardiovascular Events (MACE).
- To assess the safety and adverse event profile associated with high-dose atorvastatin therapy.
- To compare the outcomes of 80 mg atorvastatin against lower doses and placebo in a meta-analysis.
Summary:
- A meta-analysis of six randomized clinical trials (29,333 patients) compared atorvastatin 80 mg, 10 mg, and placebo.
- High-dose atorvastatin (80 mg) demonstrated a 20% reduction in MACE (RR 0.8, NNT 30-55).
- Adverse event analysis showed a relative risk of 2.37 (NNH 14-19), with similar safety concerns compared to lower atorvastatin doses.
Impact:
- High-dose atorvastatin (80 mg) is confirmed as an effective strategy for secondary MACE prevention.
- Clinicians should consider the established efficacy and manageable adverse event profile when prescribing 80 mg atorvastatin.
- This evidence supports optimizing statin therapy for patients at high cardiovascular risk.
Introduction:
Atorvastatin has been used in the management of dyslipidemia and little is known about the efficacy and safety of high-dose atorvastatin administration for secondary prevention of Major Cardiovascular Events (MACE).
Objective:
To evaluate the impact of high-dose atorvastatin on secondary prevention of MACE and adverse events.
Material And Methods:
A systematic review and meta-analysis of Pubmed, Embase, Bireme and Cochrane Library Plus databases was performed, with a time scope from 1990 to July 2022. Six randomized clinical trials were included with a total of 29,333 patients who were treated with 80 mg, 10 mg or placebo doses of Atorvastatin where the main outcomes evaluated were Major Cardiovascular Events (MACE), mortality and treatment safety.
Results:
In the comparative study between the use of Atorvastatin 80 mg and other therapies, a relative risk (RR) of 0.8 (95%CI 0.69-0.92) was found, representing a 20% reduction in risk (RRR) and a number needed to treat (NNT) of 30-55. In the analysis of adverse effects, an RR of 2.37 (95% CI 0.86-6.53) and a number needed to harm (NNH) of 14-19 were observed. The use of 80 mg atorvastatin is associated with similar adverse events at lower doses.
Conclusions:
The use of atorvastatin 80 mg is effective in the secondary prevention of Major Cardiovascular Event (MACE). The drug has adverse events that should be taken into account in secondary prevention.
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