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Comparison between 20 mg versus 40 mg dose of atorvastatin among dyslipidemic patients associated with diabetes or coronary artery disease: a randomized clinical trial

Hashem M. Mansour, Hassan Abbobaid. Abu Obaid, Waseem A. Bursh, Khamis Elessi.




Abstract

Treatment of dyslipidemia among patients with diabetes or vascular disease improves patients’ outcome. Statins are the most popular drugs used, but there is controversy on the optimum dose. In this study we aim to compare atorvastatin 20 mg versus atorvastatin 40 mg on lipid profile. Fifty five newly diagnosed patients suffering from dyslipidemia associated with diabetes or coronary artery disease aged(20–75) years with fasting total cholesterol concentrations (200 mg/L) or more and Triglyceride level 250 mg/L were randomly assigned to atorvastatin 20 mg or atorvastatin 40 mg. The lipid profile was taken at the start of study (baseline data) and after 6 months (final data). We planned follow-up for an average of 6 months. Data were analyzed using SPSS version 20. For statistical analysis the paired sample t test and the independent sample t test were used.Treatment was completed for 6 months. There were improvement in the lipid profile in both doses (p=0.05). No significant differences were found in lipid profile between the two groups except in cholesterol level (P-value 0,01) while regarding the remaining variables (TG, HDL, LDL, F.B.S,SGOT,SGPT) P-values were not statistical significantly different (0.776, 0.201, 0.383, 0.256, 0.832, 0.449 respectively). Atorvastatin lowered LDL by 23% as well as improved HDL by 6,3%. The reductions of lipid profile with atorvastatin were large with both doses (20 and 40 mg). Furthermore there is no difference between the two doses. Therefore it is recommended to start with the lower dose.

Key words: Dyslipidemia, atorvastatin, diabetes mellitus, coronary heart disease






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