Document Detail


Effect of pravastatin-to-simvastatin conversion on low-density-lipoprotein cholesterol.
MedLine Citation:
PMID:  11571816     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
The effects of a pravastatin-to-simvastatin conversion program on low-density-lipoprotein (LDL) cholesterol levels were studied. Patients receiving pravastatin at a Veterans Affairs medical center were switched to simvastatin beginning in 1997. The dosage of simvastatin was based on the additional percent reduction in LDL cholesterol needed to achieve the goal specified by the National Cholesterol Education Program. The primary endpoint was the change in the percentage of patients meeting their LDL cholesterol goal at baseline and follow-up. Changes in lipid indices, the relative risk (RR) of coronary heart disease (CHD), and program costs were also evaluated. A total of 1032 patients completed the program. The mean +/- S.D. daily doses of pravastatin and simvastatin were 25.2 +/- 11.3 and 22.7 +/- 13.3 mg, respectively. Median baseline and follow-up LDL cholesterol concentrations were 116 and 99 mg/dL, respectively (p < 0.001). Overall, 44% of the patients met their LDL cholesterol goal while taking pravastatin, compared with 69% after conversion to simvastatin (p < 0.001). The predicted mean RR of a future CHD event (based on changes in serum lipids) was 0.87 (95% confidence interval, 0.83-0.91) four years after conversion. The total cost of the program was $40,644 in the first year, and there was a net saving thereafter. Therapeutic interchange between pravastatin and simvastatin increased the number of patients meeting their LDL cholesterol goal.
Authors:
M K Ito; J C Lin; A P Morreale; D B Marcus; R Shabetai; T R Dresselhaus; R R Henry
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  American journal of health-system pharmacy : AJHP : official journal of the American Society of Health-System Pharmacists     Volume:  58     ISSN:  1079-2082     ISO Abbreviation:  Am J Health Syst Pharm     Publication Date:  2001 Sep 
Date Detail:
Created Date:  2001-09-26     Completed Date:  2002-02-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9503023     Medline TA:  Am J Health Syst Pharm     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1734-9     Citation Subset:  IM    
Affiliation:
Southern California Clinical Experience Program, School of Pharmacy and Health Sciences, University of the Pacific (UOP), Stockton, USA. uopito@aol.com
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MeSH Terms
Descriptor/Qualifier:
Aged
Anticholesteremic Agents / administration & dosage*,  economics
Chi-Square Distribution
Cholesterol, LDL / blood,  drug effects*
Coronary Disease / prevention & control
Drug Administration Schedule
Female
Hospitals, Veterans
Humans
Hyperlipidemias / drug therapy*
Male
Middle Aged
Pharmacy Service, Hospital
Pravastatin / administration & dosage*
Prospective Studies
Risk Factors
Simvastatin / administration & dosage*
Statistics, Nonparametric
Treatment Outcome
Chemical
Reg. No./Substance:
0/Anticholesteremic Agents; 0/Cholesterol, LDL; 79902-63-9/Simvastatin; 81093-37-0/Pravastatin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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