is atorvastatin actually much better than simvastatin?
A careful analysis of two large trials (PROVE IT-TIMI 22, and A to Z) that examined lipid-lowering strategies early after acute coronary syndromes (ACS) concludes that apparent disparities in their results were as likely to have been due to differences in patients included and trial endpoints chosen as in the drugs used. PROVE IT-TIMI 22 compared pravastatin against atorvastatin, and A to Z compared tirofiban plus unfractionated heparin to enoxaparin, and moderate-dose with high-dose simvastatin. Headline results from the trials suggested that atorvastatin 80mg gave significantly better clinical outcomes than high-dose (80mg) simvastatin. The authors used the original patient data from the trials, to which they had full access, to analyse similarities and differences in the design, implementation, and results of the two trials. Their aim was to clarify the risks and benefits of statin therapy after ACS. In each trial, comparisons were made between intensive and moderate arms for both t
