Eficacia de la atorvastatina en el tratamiento de las dislipemias refractarias

Abstract

Background: the application of the clinical studies in the daily practice could evidence differences with the preliminary results carried out under standard conditions. Objectives: evaluating the efficacy of the atorvastatin in patients with refractory dislipemia to other hypolipemiants treatments. Evaluating analytic secondary alterations. Design, material and methods: clinical prospective study type before-later, carried out in a Basic Area of urban Health, on one serial sample of 43 patients with hypercholesterolaemia in whom there was verification of the previous failure of other hypolipemiant drug. We substituted the previous treatment and we immediately prescribed atorvastatin (10 mg/ day) for twelve months, evaluating total cholesterol, LDL and trigliycerides before and after the treatment. We determined hepatic function, renal, muscular enzymes, clotting and fibrinogen. We carried out statistical analysis by means of t of Student for data rhyming couplets, considering significant differences if p< 0.05. Results: the main observed results show reduction in levels of total cholesterol of 83.4 mg/dl (IC 95%: ′13.3), in LDL-cholesterol of 65.8 mg/ dl (IC 95%: ′11.2) (significant differences in both); in triglycerides and fibrinogen doesn't exist significant differences. We did not observe significant differences in hepatic, renal and muscular parameters in any case. Conclusions: the atorvastatin, to low dose, is highly effective in order to reduce lipidicals parameters in refractory patients to other hypolipemiants. This study shows a supplementary decrease of the 31.6% of the LDL-cholesterol concerning the previous figures after other treatments. Although studies on reduction of mortality in dislipidemics lack, the atorvastatin could be converted in a first line drug in the therapeutic handling of the subpoblation of patients with refractory hyperlipidemia, especially other inhibitors of HMG-CoA. We highlighted that, to this dose, we didn't evidence no secondary clinical neither analytic effect.