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Comparative Effect of Atorvastatin (80 mg) Versus Simvastatin (20 to 40 mg) in Preventing Hospitalizations for Heart Failure in Patients With Previous Myocardial Infarction
University of Oulu.
Ullevaal University Hospital.
Arhus University Hospital.
University of Amsterdam.
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2009 (English)In: AMERICAN JOURNAL OF CARDIOLOGY, ISSN 0002-9149, Vol. 103, no 10, 1381-1385 p.Article in journal (Refereed) Published
Abstract [en]

We investigated whether intensive cholesterol lowering could more effectively prevent heart failure (HF) in secondary prevention. The IDEAL study was a 4.8-year prospective, randomized trial comparing "usual" simvastatin treatment (20 to 40 mg/day, n = 4,449) with high-dose atorvastatin (80 mg/day, n = 4,439) in patients with a history of myocardial infarction (MI). At baseline, 94% of patients (n = 8,351) had no history of HF. During the course of the trial, there were 222 new or recurrent hospitalizations for HF (57 and 165 in those with and without HF at baseline, respectively), 123 (2.8%) in the simvastatin group and 99 (2.2%) in the atorvastatin group (hazard ratio [HR] 0.81, 95% confidence interval [CI] 0.62 to 1.05, p = 0.11). After adjustments, atorvastatin 80 mg was associated with a 26% decrease of new HF events compared with simvastatin 20 to 40 mg (HR 0.74, 95% CI 0.57 to 0.97, p = 0.03). Atorvastatin tended to be associated with fewer HF events in those with HF at baseline (n = 537, HR 0.65, 95% CI 0.38 to 1.11, p = 0.11) and those without HF at baseline (n = 8,351, HR 0.80, 95% CI 0.59 to 1.09, p = 0.15). Also, HF without preceding MI (n = 187) was decreased (HR 0.73, 95% CI 0.54 to 0.97, p = 0.03). In conclusion, atorvastatin 80 mg was more efficient than simvastatin 20 to 40 mg in preventing development of HF in patients with previous MI.

Place, publisher, year, edition, pages
2009. Vol. 103, no 10, 1381-1385 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-19152DOI: 10.1016/j.amjcard.2009.01.377OAI: diva2:223417
Available from: 2009-06-12 Created: 2009-06-12 Last updated: 2009-08-21

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Olsson, Anders
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Internal Medicine Faculty of Health SciencesDepartment of Endocrinology and Gastroenterology UHL
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ReferencesLink to record
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