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Časopis Cardiology for practice – Článok Comparison of 40 mg and 60 mg doses of atorvastatin in high-risk patients in primary and secondary prevention

Cardiology for practice

Reviewed, postgraduate scientific medical journal.
Period 4x per year
1336-3433
Free full text. The journal is indexed in the Slovak National Bibliography, Bibliographiia Medica Slovaca (BMS) and listed to citation database CiBaMed. All articles are reviewed. The publisher does not bear any responsibility for data and opinions of particular authors of the articles or advertisements. The articles on grey pages are company promotions or non reviewed information, an author is responsible for the content. Any reproduction of the content is allowed only with direct consent of the editorial office.
Predplatné
Cardiology for practice
Cardiology for practice
Reviewed, postgraduate scientific medical journal.
Period 4x per year
Téma: Various

Comparison of 40 mg and 60 mg doses of atorvastatin in high-risk patients in primary and secondary prevention

Martin Čaprnda, Ján Farkašovský, Oliver Tlčimuka

Introduction: Dyslipidemia is one of the most significant risk factors for cardiovascular diseases. Its diagnosis and
treatment is managed by general practitioners as well as specialists. Atorvastatin (ATST) at 80 mg dose is used primarily
in patients high and very high cardiovascular risk in both primary and secondary prevention. However, some
patients require statin dose reduction, most frequently due to adverse effects. The aim of this study (project ATORNOVA
60 – Phase 2) was to identify patients treated for dyslipidemia using ATST 80 mg, who required statin dose
reduction, and to compare the efficacy and safety of ATST doses reduced to 40 mg and 60 mg.
Methodology: The ATORNOVA 60 project was conducted in the form of a prospective, non-randomized, open-label
trial of 6-month duration. Phase 2 of the project included a total of 449 patients aged 33–88 (222 men, and 227
women), who required statin dose reduction. The patients received ATST doses reduced to 40 mg or 60 mg at the
discretion of their attending physicians. The patients were educated about the need to adhere to both non-pharmacological
and pharmacological hypolipidemic treatment. Three and six month later, lipid level and safety parameters
were checked (creatine kinase – CK, alanine aminotransferase – ALT). The project was supported by KRKA’s
research grant.
Results: At the beginning of the trial, patients in the ATST40 group manifested slightly lower level of total cholesterol
(Tot-C) (4.72 ± 1.51 vs. 5.07 ± 2.06; p = 0.040), LDL cholesterol (LDL-C) (2.64 ± 1.19 vs. 2.94 ± 1.65; p < 0.024),
and non-HDL cholesterol (nonHDL-C) (3.47 ± 1.53 vs. 3.83 ± 2.09; p = 0.035). There were no differences in TAG
levels (1.79 ± 1.12 vs. 1.74 ± 0.83; p = NS) and HDL-C (1.25 ± 0.38 vs. 1.24 ± 0.39; p = NS). The most common
reason for dose reduction were adverse effects of ATST: myalgia, gastrointestinal problems, hepatopathy, elevated
CK. After 6 months of treatment we surprisingly recorded a slight decrease in the levels of Tot-C, LDL-C and non-
HDL-C (statistically significant only in the ATST60 group), and a slight increase in HDL-C (statistically significant in
both groups). When evaluating the safety parameters, we observed a decrease in absolute CK values in both monitored
groups, and a decrease in ALT in the ATST60 group. There was also a decrease in the percentage of patients
who exceeded 1-fold and 3-fold the normal CK and ALT values.
102 Kardiológia pre prax 2/2018
Conclusion: In this group of patients treated with ATST 80 mg, who required statin dose reduction, there was
a slight decrease in the levels of total, LDL and nonHDL cholesterol despite dose reduction, with lower levels being
achieved in the group of patients receiving ATST 60 mg. In most patients, dose reduction led to a decrease, respectively
normalization, of elevated values of monitored safety parameters (CK, ALT).

Kardiol. Prax 2018; 16 (2): 101-107
CHAIRMAN OF THE EDITORIAL BOARD
doc. MUDr. Oľga Jurkovičová, CSc.

CHIEF CONSULTANT
prof. MUDr. Robert Hatala, PhD., FESC

MEMBERS OF THE EDITORIAL BOARD
MUDr. Peter Dědič
MUDr. Juraj Dúbrava, PhD., FESC
MUDr. Viliam Fridrich, PhD.
doc. MUDr. Ján Kmec, PhD.
MUDr. Gabriela Kaliská, PhD., FESC
MUDr. Pavol Lesný
MUDr. Monika Kaldarárová, PhD.
MUDr. Peter Margitfalvi
prof. MUDr. Daniel Pella, PhD.
prof. MUDr. Iveta Šimková, CSc., FESC
MUDr. Viera Vršanská, CSc.

PROFESSIONAL EDITOR
MUDr. Juraj Dúbrava, PhD., FESC

EDITOR-IN-CHIEF
Ing. Danica Paulenová
e-mail: paulenova@amedi.sk

GRAPHIC LAYOUT AND TYPESETTING
Lucia Vecseiová
e-mail: dtp@amedi.sk

MARKETING MANAGER
Ing. Dana Lakotová
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e-mail: marketing@amedi.sk

ECONOMY AND SUBSCRIPTIONS
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telefón: 02/55 64 72 48
mobil: 0911 117 949
e-mail: ekonom@amedi.sk

LANGUAGE PROOFREADING
Mgr. Eva Doktorová

PROOFREADING OF ENGLISH TEXTS
Mgr. Jana Bábelová
SECTIONS

OVERVIEW PAPERS
The latest knowledge on disease and disease groups aetiology, pathogenesis, diagnoses and therapy. Maximum size is 8 pages (font size 12, line spacing 1.5) with maximum five pictures (graphs). In case of more extensive theme elaboration it is possible to divide the paper to several parts after agreement with editorial office. Write the article with emphasis on its practical usage for cardiologists.

CASE STUDY 
Maximum extent is 7 pages. Structuring: summary, introduction, case study, discussion, conclusion, bibliography.

DIAGNOSTIC AND THERAPEUTICAL ALGORITHMS
Diagnosis and therapy processed into tables and schemes, with minimum text, with emphasis on conciseness and clarity.

MISCELLANEOUS
Reaction to overview articles, news in the field of diagnostics, therapy, trial results (maximum 3 pages), reports from professional events, abstracts from scientific work published abroad, not older than 1 year. Maximum extend is 1 page. Write the title of the paper in Slovak/Czech, authors, workplace, than title of the paper in English with full citation.

FROM BORDERLINE OF CARDIOLOGY
Inter sectional theme elaborated complexly, well-arranged, clear (extent up to 8 pages).


MANUSCRIPT ELABORATION

Write the paper on computer in any common text editor.
- write full length of lines (do not use ENTER at the end of a line)
- do not arrange text into columns
- do not do page make-up, put tables at the end of the paper
- distinguish precisely numbers 1, 0 and letters l, O
- use always parentheses ( )
- explain abbreviations always when first used


MANUSCRIPT REQUIREMENTS

1. An accurate paper title, names and surnames of all authors including academic titles, authors` workplace. The first author address including the phone number, fax and e-mail address.
2. Summary - concise content summary in the extent maximum 10 lines (only at overview papers, case studies from borderline of cardiology). Write in 1st or 3rd person singular or plural (unify according the type of an article).
3. Key words - in the extent of 3-6 (just at overview papers, From borderline of cardiology).
4. English translation: paper title, summary, key words (only at overview papers, case studies and From borderline of cardiology)
5. Text
If you insert pictures into a document, send also their original files in "jpg" format, create graphs in Excel and send also their original files. If you send photo documentation via post office, please, send just high-class originals. Mark each original by a number, under which it is mentioned in the text. Write in 1st or 3rd person singular or plural (unify according the type of an article).
6. Bibliography
Citations are numbered chronologically in bold, references in the text are stated by the number of citations in parentheses. Use maximum 30 citations.

Examples of citations:
1. Shaheen NJ, Crosby NA, Bozymski EM, et al. Is there publication bias in the reporting cancer risk in Barrett´ esophagus? Gastroenterology 2000; 119: 333-338.
2. Stenestrand U, Wallentin L. Swedish Register of Cardiac Intensive Care (RIKS-HIA): Early statin treatment following acute myocardial infarction and 1-year survival. JAMA 2001; 285: 430-436.
3. LIPID Study Group. Prevention of cardiovascular events and death with pravastatin in patients with coronary heart disease and a broad range of initial cholesterol levels. N Engl J Med 1998; 339: 1349-1357.
4. Jurkovičová O, Spitzerová H, Cagáň S. Komorové arytmie a náhla srdcová smrť pri akútnom infarkte myokardu. Bratisl Lek Listy 1997; 98: 379-389.
5. Osborne BE. The electrocardiogram of the rat. In: Budden R, Detweiler DK, Zbinden G. The rat electrocardiogram in pharmacology and toxicology. Oxford: Pergamon Press 1981: 15-27.

Do not use dots after first names in citations. Do not use colon but dot after names of authors. Use semi-colon after the year of publishing, colon is before pages. If an author is one, two or three - it is necessary to state all. If there are more than three authors it is necessary to write first three and "et all", in Slovak and Czech citations "a spol."

Due to publishing of autodidactic tests it is necessary to add 4 questions to your article and 4 answers with marking of one correct answer, e.g.:

In which patients, after overcoming of a thromboembolic cerebral or peripheral event, the least suitable catheter closure is foramen ovale patents:
a. a woman before planned pregnancy
b. paroxysmal fibrillation of the atrium
c. aneurysm of the atrium septum
d. origination of an event after cough

The editorial office reserves the right to make small stylistic changes in the paper. If it is necessary to shorten the paper, the consent of the author will be required. All articles are double reviewed.

All published papers are paid.

Due to practical focus of the journal we would like to ask you write the paper comprehensively, with emphasis on practical use of provided information in out-patient practice of cardiologists, internists and other professionals who deal with cardiovascular medicine.

Send contributions in the e-mail to the address: paulenova@amedi.sk
Period 4x per year
1336-3433
Free full text. The journal is indexed in the Slovak National Bibliography, Bibliographiia Medica Slovaca (BMS) and listed to citation database CiBaMed. All articles are reviewed. The publisher does not bear any responsibility for data and opinions of particular authors of the articles or advertisements. The articles on grey pages are company promotions or non reviewed information, an author is responsible for the content. Any reproduction of the content is allowed only with direct consent of the editorial office.
Predplatné
Cardiology for practice
Cardiology for practice
Reviewed, postgraduate scientific medical journal.
Period 4x per year