LDL-C and TC lowering was significantly greater in the evening dose than in the morning dose in case of short-acting statins .
Besides slight but significant effect on LDL-C , the efficacy of long-acting statins was equivalent for both regimens .
BACKGROUND Evidence about the optimal time of day at which to administer statins is lacking .
OBJECTIVE The objective of this study is to synthesize evidence about effects of morning vs evening statin administration on lipid profile .
Lipoprotein changes and reduction in the incidence of major coronary heart disease events in the Scandinavian Simvastatin Survival Study (4S)
BACKGROUND The Sc and inavian Simvastatin Survival Study ( 4S ) r and omized 4444 patients with coronary heart disease ( CHD ) and serum cholesterol 5.5 to 8.0 mmol/L ( 213 to 310 mg/dL ) with triglycerides < or = 2.5 mmol/L ( 220 mg/dL ) to simvastatin 20 to 40 mg or placebo once daily . Over the median follow-up period of 5.4 years , one or more major coronary events ( MCEs ) occurred in 622 ( 28 % ) of the 2223 patients in the placebo group and 431 ( 19 % ) of the 2221 patients in the simvastatin group ( 34 % risk reduction , P<.00001 ) . Simvastatin produced substantial changes in several lipoprotein components , which we have attempted to relate to the beneficial effects observed . METHODS AND RESULTS The Cox proportional hazards model was used to assess the relationship between lipid values ( baseline , year 1 , and percent change from baseline at year 1 ) and MCEs . The reduction in MCEs within the simvastatin group was highly correlated with on-treatment levels and changes from baseline in total and LDL cholesterol , apolipoprotein B , and less so with HDL cholesterol , but there was no clear relationship with triglycerides . We estimate that each additional 1 % reduction in LDL cholesterol reduces MCE risk by 1.7 % ( 95 % CI , 1.0 % to 2.4 % ; P<.00001 ) . CONCLUSIONS These analyses suggest that the beneficial effect of simvastatin in individual patients in 4S was determined mainly by the magnitude of the change in LDL cholesterol , and they are consistent with current guidelines that emphasize aggressive reduction of this lipid in CHD patients
LDL-C and TC lowering was significantly greater in the evening dose than in the morning dose in case of short-acting statins .
Besides slight but significant effect on LDL-C , the efficacy of long-acting statins was equivalent for both regimens .
BACKGROUND Evidence about the optimal time of day at which to administer statins is lacking .
OBJECTIVE The objective of this study is to synthesize evidence about effects of morning vs evening statin administration on lipid profile .