Comparison of Cardiovascular Event Rates in Patients Without Cardiovascular Disease in Whom Atorvastatin or Simvastatin Was Newly Initiated

Cardiovascular and Economic Outcomes After Initiation of Lipid-Lowering Therapy With Atorvastatin vs Simvastatin in an Employed Population

“…25 Multiple studies have shown that atorvastatin significantly reduces high-sensitivity C-reactive protein levels, 26-29 whereas a study of simvastatin found reductions of smaller magnitude, 30 and a comparative study found that atorvastatin was associated with greater high-sensitivity C-reactive protein reductions compared with simvastatin. 31 Previous observational studies of statin therapy in the general (not necessarily employed) population for both primary prevention and all new statin users [13][14][15] have consistently shown a relative risk reduction associated with atorvastatin therapy of 10% to 13%, which is roughly in line with the 9% relative risk reduction in our analysis. Taken together, the consistency across studies suggests a robust association between initiation with atorvastatin and reduced cardiovascular risk that is not sensitive to differences across administrative claims databases, statistical methods (Cox regression vs propensity score matching), employment status, or small variations in sample selection and study design.…”

“…Better adherence to atorvastatin may contribute to this explanation. 14,22,23 In addition, evidence suggests that the 2 agents may differ in their nonlipid effects, such as the reduction in inflammation. 24 The association between inflammatory markers and cardiovascular events has received increased attention after the publication of JUPITER (Justification for the Use of Statins in Primary Prevention: An Intervention Trial Evaluating Rosuvastatin), in which rosuvastatin therapy was shown to benefit patients with normal low-density lipoprotein cholesterol levels (<130 mg/dL) but elevated levels of the inflammatory marker C-reactive protein.…”

“…A similar grouping of cardiovascular events has been studied in prior analyses of atorvastatin and simvastatin on the basis of different sources of administrative claims data. 14 The total cost outcomes examined in the current study include all-cause medical costs (services and prescription drugs) in addition to indirect costs incurred through work loss and disability payments and thus represent total costs from an employer perspective. To provide a complete characterization of outcomes for the study cohorts, rates of medical service use (outpatient, inpatient, and emergency department visits), medication use, work loss hours, and all-cause and cardiovascular-related prescription costs were also studied.…”

“…12 In observational studies of large US administrative insurance claims databases, atorvastatin treatment has been associated with a lower risk of cardiovascular-related hospital admissions compared with simvastatin treatment among all patients in whom statin therapy was initiated 13 and among patients free of cardiovascular disease in whom statin therapy was initiated for primary prevention. 14,15 Similarly, in analyses of a general practice research database in the Netherlands, new statin users who were prescribed atorvastatin expe-OBJECTIVE: To compare the risk of cardiovascular-related hospitalization, statin adherence, and direct (medical and drug) and indirect (disability and medically related absenteeism) costs in US employees in whom atorvastatin or simvastatin was newly prescribed.…”

Comparison of Effects of Simvastatin Versus Atorvastatin on Oxidative Stress in Patients With Coronary Heart Disease

“…Some report no difference between the 2 statins on clinical outcome, 35,36 although others demonstrate an advantage of atorvastatin over simvastatin in reducing cardiovascular events. 37 Furthermore,there are studies comparing the antiinflammatory and antioxidant capacity of these 2 statins. 38 To our knowledge, no other study compared the effects of simvastatin and atorvastatin on markers of oxidative stress in patients with CHD.…”