Tag Archives: switching

The authors advance the hypothesis that patients switched from atorvastatin to simvastatin are at greater risk of cardiovascular events and on this basis suggest that formal randomised trials are desirable. Their concerns around the potential implications of the current policy for switching statins would, if founded, have far-reaching consequences and therefore the study necessitates close scrutiny. Grading of evidence Case-control studies are the lowest grade of evidence among observational studies, the findings of which should always be referred to well-conducted randomised controlled trials where these are possible. This case-control study

A total of 2,511 switch patients and 9,009 controls were identified. The risk of death or first major cardiovascular event was significantly associated with switching therapy (hazard ratio = 1.30, 95% confidence interval: 1.02–1.64) compared with patients who did not switch. Major cardiovascular events and stroke were also significantly associated with switching. There was no significant difference in all-cause mortality.  While recognising the observational nature of database research, this study has highlighted the potential for poorer cardiovascular outcomes in patients switching statin therapy, compared with patients maintained on thei