Lipid-lowering therapy is effective in reducing cardiovascular mortality and morbidity in people with PAD .
It may also improve local symptoms .
Until further evidence on the relative effectiveness of different lipid-lowering agents is available , use of a statin in people with PAD and a blood cholesterol level > /=3.5 mmol/litre is most indicated
BACKGROUND Lipid-lowering therapy is recommended for secondary prevention in people with coronary artery disease .
It may also reduce cardiovascular events and /or local disease progression in people with lower limb peripheral arterial disease ( PAD ) .
OBJECTIVES To assess the effects of lipid-lowering therapy on all-cause mortality , cardiovascular events and local disease progression in patients with PAD of the lower limb .
Cost-minimization analysis of simvastatin versus atorvastatin for maintenance therapy in patients with coronary or peripheral vascular disease.
BACKGROUND Previous health economic studies have demonstrated the cost-effectiveness of simvastatin in the treatment of coronary heart disease ( CHD ) based on clinical results of the Sc and inavian Simvastatin Survival Study . A prior analysis evaluated the " cost of getting to goal , " but ignored all costs after titration . However , when evaluating the cost-effectiveness of long-term therapies , it is important to consider the maintenance costs as well . OBJECTIVE The purpose of this study was to evaluate the maintenance costs of treatment with simvastatin versus that of treatment with another more recently available statin , atorvastatin , in a European context . METHODS We assessed the long-term maintenance cost of simvastatin versus atorvastatin in terms of the cost of reducing low-density lipoprotein cholesterol ( LDL-C ) levels to the recommended goals based on a previously published clinical trial in patients with CHD . The analysis focused on the patients in the original clinical trial who were r and omized to treatment with simvastatin or atorvastatin . Patients began therapy with 10 mg of simvastatin or atorvastatin ;  the dose of study drug was titrated every 12 weeks up to 40 mg simvastatin or 80 mg atorvastatin , with the addition of up to 8 g/d of cholestyramine until a modified European Atherosclerosis Society LDL-C goal ( < 2.84 mmol/L ) was reached . As there was no significant difference between the 2 groups in re source utilization for adverse events , only drug costs were included . The calculated average annual maintenance cost was based on the distribution of the final daily dosing regimens and the public drug prices for each regimen . Individual country analyses were conducted using each local currency . RESULTS There was no significant difference between groups in the percentage of patients reaching their LDL-C goal over the study period ( 80 % for simvastatin-treated  pa- tients vs 89 % for atorvastatin-treated  patients , P = 0.135 ) . However , the cost of maintaining a similar percentage of patients at their appropriate LDL-C levels was significantly lower in the  simvastatin group compared with the atorvastatin group in 13 of the 17 countries assessed . In the remaining 4 countries , there was a cost advantage for simvastatin , but it did not reach statistical significance . CONCLUSIONS Across Europe there was a significant reduction in the cost of maintaining patients at their appropriate LDL-C levels with simvastatin versus atorvastatin . The results of this analysis , along with the proven clinical benefits of simvastatin , support the use of this drug as the treatment of choice in the secondary prevention of CHD
Lipid-lowering therapy is effective in reducing cardiovascular mortality and morbidity in people with PAD .
It may also improve local symptoms .
Until further evidence on the relative effectiveness of different lipid-lowering agents is available , use of a statin in people with PAD and a blood cholesterol level > /=3.5 mmol/litre is most indicated
BACKGROUND Lipid-lowering therapy is recommended for secondary prevention in people with coronary artery disease .
It may also reduce cardiovascular events and /or local disease progression in people with lower limb peripheral arterial disease ( PAD ) .
OBJECTIVES To assess the effects of lipid-lowering therapy on all-cause mortality , cardiovascular events and local disease progression in patients with PAD of the lower limb .