By Bruce Sylvester
CHICAGO -- April 2, 2008 -- Atorvastatin monotherapy is as effective as amlodipine monotherapy and a combination of the two drugs for reducing transient myocardial ischaemia (TMI) in patients with chronic stable angina, researchers reported here at the 57th Annual Scientific Session of the American College of Cardiology (ACC 2008).
"What we found, very unexpectedly, was that the statin was as effective an antianginal and anti-ischaemic drug as the traditional medications we use for treating angina and ischaemia.," said lead investigator John Deanfield, MD, Professor of Cardiology, University College, London, United Kingdom. "Within 18 weeks, the statin had virtually eliminated any evidence of ischaemia during the patient's normal daily activity."
In the Double-Blind Atorvastatin Amlodipine (DUAAL) study, Dr. Deanfield and colleagues randomised subjects with coronary artery disease and chronic stable angina to atorvastatin (n=103), amlodipine (n=104), or a combination of the two drugs (n=104). Subjects also received usual care therapy for coronary artery disease, which included beta-blockers, long acting nitrates, and aspirin.
The randomised, double-blind, parallel-group, multi-country trial had a 2-week run-in phase followed by 24 weeks of active therapy, titrated at week 6.
At endpoint, the investigators reported that TMI episodes decreased by 66%, and 50% of all subjects became TMI free in all 3 groups. The investigators also reported a marked reduction in angina and nitroglycerin consumption.
Notably, atorvastatin therapy was as effective as amlodipine for relief of TMI.
In addition, the inflammation marker C-reactive protein decreased by 40% among atorvastatin subjects, with no change among amlodipine subjects.
Adverse events were comparable across groups.
"This is a novel finding, and one which will interest most physicians," said Dr. Deanfield.
Funding for this study was provided by Pfizer, Inc.
[Presentation title: Effect of Amlodipine, Atorvastatin and the Combination on Transient Myocardial Ischemia in Coronary Artery Disease From the DUAAL Study. Poster 1032-42]
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