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    3. CHD in India 60 million(6 crore) people affected ICMR study: 103.2/1000 in males and 100.3/1000 in females (urban) People affected are 5-10 years younger than in the west More diffuse atherosclerosis

    4. Prevalence of CHD in Delhi(Age group : 35–64 yrs.) Urban Rural Males 10.9% 5.5% Females 10.2% 6.4% Sethi K.K. Coronary Artery Disease in Indians, 1998

    5. Benefits of statins (as per results of various prospective randomised trials) Arrests as well as prevents the process of atherosclerosis Reduces total and cardiovascular mortality Reduces CHD events such as nonfatal myocardial infarction, angina Reduces incidence of heart failure Reduces the risk of cerebrovascular events such as stroke Reduces need for revascularisation procedures such as angioplasty / bypass surgery Reduces number of hospitalisations/duration of hospital stay Ann Pharmacother 1998; 32: 1030–1043 Atheroscler 1999; 143 (suppl 1): S17–S21

    6. Orally active drug Inhibits HMG-CoA reductase Causes significant reduction in total cholesterol, LDL cholesterol, VLDL cholesterol and triglycerides, and increases HDL cholesterol May be taken at any time of the day May be taken with or without food Drugs 1997; 53: 828-847 Atorvastatin:An overview

    8. Line plot of reductions in LDL cholesterol by atorvastatin as a function of dose and time.

    9. Number and Percentage of Patients Achieving NCEP LDL Goal According to Treatment Group Treatment Group

    14. Occurrence of Ischemic Events According to Treatment Group (AVERT Study) No. of patients No. of No. of patie- No. of for whom patients nts for whom patients the event was (%) with the event (%) with the first the event was the first the event* Death from cardiac causes 1 1 (0.6) 1 1 (0.6) Non-fatal myocardial infarction 2 4 (2.4) 4 5 (2.8) Coronary artery bypass grafting 0 2 (1.2) 3 9 (5.1) Angioplasty as an event 9 18 (11.0) 5 21 (11.9) Worsening angina with objective 10 11 (6.7) 24 25 (14.1)evidence of myocardial ischemiaresulting in hospitalization Any ischemic event 22 (13.4) 37 (20.9) * Twenty nine of the patients in the angioplasty group underwent a revascularization procedure after the assigned angioplasty. One of the patients in the angioplasty group underwent both coronary artery bypass grafting and angioplasty

    16. Adverse Events Associated with Treatment Experienced by 2% or more of Patients Treated with Atorvastatin or Other Statins OtherAdverse Atorvastatin StatinsEvent (n=2502) (n=742) Constipation 3 5 Flatulence 2 3 Dyspepsia 2 2 Abdominal pain 2 2 Headache 1 2 Myalgia 1 2 Any event 20 24

    17. Atorvastatin: Dosage The recommended starting dose of atorvastatin is 10 mg daily. The dosage range is 10 to 80 mg once daily

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