n Cardiovascular Journal of South Africa - A single-centre retrospective observational study to evaluate the change in total cholesterol and LDL cholesterol in hyperlipidaemic patients switched from atorvastatin to simvastatin : cardiovascular topics




The clinical effects of switching from one HMG Co-A reductase inhibitor (atorvastatin) to another therapeutic agent within the same class (simvastatin) were examined in this observational study. Levels of total-C, LDL-C, HDL-C and triglycerides from 100 patients were compared before and after switching, and the maintenance, improvement or loss of lipid control was assessed. There was a significant increase in total-C and triglycerides (&lt;I&gt;p&lt;/I&gt; < 0.05) following the switch from atorvastatin to simvastatin. A number of patients showed &lt;u&gt;&gt;&lt;/u&gt; 10% variation in lipid levels after switching. The high intrapatient variation seen in this study strongly suggests that therapeutic substitution is associated with an unpredictable response in plasma lipid levels and their control. This would have practical implications for physicians who are considering a switch of this nature.


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