Well shit, I thought high-dose statin therapy was no longer recommended for anyone not on it already. You will need to ask your doctor which research finding they are using for guidance.
The line from there;
The agency is recommending that simvastatin 80 mg be used only in
patients who have been taking this dose for 12 months or more and have
not experienced any muscle toxicity. It should not be prescribed to new
patients.
And the new one here:
Abstract
BACKGROUND:
Clinicians
need to identify coronary artery disease patients for whom the benefits
of high-dose versus usual-dose statin therapy outweigh potential harm.
We therefore aimed to develop and validate a model for prediction of the
incremental treatment effect of high-dose statins for individual
patients in terms of reduction of 5-year absolute risk for myocardial
infarction, stroke, coronary death, or cardiac resuscitation.
METHODS AND RESULTS:
Based
on data from the Treating to New Targets trial (TNT; n=10 001), a Cox
proportional hazards model was developed comprising 13 easy-to-measure
clinical predictors: age, sex, smoking, diabetes mellitus, total
cholesterol, high-density lipoprotein cholesterol, systolic blood
pressure, history of myocardial infarction, coronary artery bypass
grafting, congestive heart failure or abdominal aortic aneurysm,
glomerular filtration rate, and treatment status (ie, atorvastatin 80 mg
or 10 mg). External validation in the Incremental Decrease in End
Points Through Aggressive Lipid Lowering trial (IDEAL; n=8888) confirmed
adequate goodness-of-fit and calibration, but moderate discrimination
(C-statistic, 0.63; 95% confidence interval, 0.62-0.65). Still, among
participants of both trials combined, the model identified a group of
11.7% whose predicted 5-year number needed to treat was ≤25 and a group
of 41.9% whose predicted needed to treat was ≥50. A decision curve shows
that making treatment decisions on the basis of predictions using our
model may improve net benefit.
CONCLUSIONS:
Estimation of
the incremental treatment effect of high-dose versus usual-dose statin
therapy in individual coronary artery disease patients enables selection
of high-risk patients that benefit most from more aggressive therapy.
CLINICAL TRIAL REGISTRATION URL:
http://www.clinicaltrials.gov. Unique identifiers: NCT00327691 and NCT00159835.
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