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- Choice of substanceShow More
You do not comment on the choice of substance: 6 of the 7 trials were comparing 80mg of atorvastatin vs. normal-intensity statin. The only trial of high-dose simvastatin (A-Z) showed no significant benefit. I hope that the SEARCH trial will provide adequate data on simvastatin. I'd suggest a sensitivity analysis using duration of trial as a variable. It seems, that the effect of high-dose atorvastatin is confined to a limit...
Competing Interests: None declared. - Statins - Safe ?Show More
Dr. Peltekian's headline announces to the readers that STATINS ARE SAFE. We only wish. Statins reduce the body's production of mevalonate through the suppression of a liver enzyme called hydroxymethylglutaryl (HMG) coenzyme A reductase. This enzyme is crucial in enabling the body to synthesize such substances as cholesterol, Co-enzyme Q-10 etc., substances that are essential for every living cell.So, if you reduce the supp...
Competing Interests: None declared. - Statins are safe. So stop checking ALT and AST in asymptomatic patients on statins!Show More
I read with interest the meta-analysis by Josan et al [1] on the safety of intensive statin therapy but was disappointed with their avoidance of commenting on the need to monitor hepatotoxicity. In their analysis, even with the intensive statin therapy only 1.5% showed elevations in serum aminotransferase (ALT) levels [1]. Unfortunately, most subjects starting statins get their ALT levels tested and retested unnecessaril...
Competing Interests: None declared.