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Pfizer's statin Lipitor (atorvastatin) went against Bristol-Myers Squibb's Pravachol (pravastatin) in a major study reported in the New England Journal of Medicine (April 8, 2004). The findings showed that especially aggressive treatment with statin drugs, intended to drive low-density lipoprotein (LDL) cholesterol levels below the recommended 100 mg/dL for heart attack patients, prevents new heart attacks and saves lives.
To determine whether the LDL level was low enough, the researchers compared 2 strategies? 40 mg a day of pravastatin (the older statin) or 80 mg of atorvastatin (the newest cholesterol- lowering drug). For the study, 4162 individuals were randomly given statin treatment within 10 days of heart attacks or severe chest pains.
The results indicated that the benefits of atorvastatin emerged within the first month of treatment and were consistent throughout the 21/2- year study. For example, death rates from all causes were 28% lower among participants taking atorvastatin, who did better in every category but stroke. Overall, 26.3% of the patients taking pravastatin had died or experienced a variety of other heart problems?including new heart attacks, bypass surgery, or chest pain? compared with 22.4% of patients on atorvastatin, for a 16% reduction in risk, said lead author Christopher Cannon, MD.
The message is that physicians should immediately begin using a more aggressive treatment before any eligible patient is discharged from the hospital, according to Dr. Cannon and other experts.