The basic drug of CVD, find the best possible combination … Full check of the effect of each ingredient

The search for the optimal combination of ingredients/drug classes for the prevention of cardiovascular disease (CVD) is in full swing.

In 2020, the American Heart Association published a study observing the effect of an aspirin + statin combination, and in 2021, the European Heart Association published the results of a large-scale study looking at the effect of antihypertensive drugs statin + aspirin, fueling vitality. of optimal combination research

The latest study showed that choosing rosuvastatin for aspirin + statin combination therapy is more effective than other statin ingredients in various indicators such as congestive heart failure, coronary heart disease, and angina pectoris.

The results of a study on the combined effect of each ingredient of aspirin and a statin, conducted by researchers including Tao Liu of the 6th People’s Hospital in Shanghai, China, were published in Scientific Reports, an international journal, on the 20th ( /10.1038/s41598 -023-31739-w).

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Aspirin, a nonsteroidal anti-inflammatory drug, reduces the risk of major vascular events by 15-20% when used as a first-line CVD prophylactic through its multiple anti-inflammatory actions.

Statins, a treatment for dyslipidemia, also reduce the risk of morbidity and mortality in patients with atherosclerotic CVD through cholesterol-lowering effects.

As of 2020, large-scale studies comparing the effects of aspirin and statins or looking at changes in CVD risk when using various aspirin-based ingredients are being published.

In fact, when aspirin + statin is used as the primary CVD preventive drug, the risk of cardiovascular events is reduced by 30 to 40%, which is better than single drugs in terms of effectiveness.

Researchers including Tao Liu focused on the fact that the statin ingredients are diverse and that the effects and side effects of each ingredient are very different even though they are in the same class, and research began on the best possible statin ingredient with aspirin.

Of the 16,000 people who took part in the National Health and Nutrition Examination Survey (NHANES) between 2011 and 2018, a total of 3,778 people were included in the analysis, excluding those missing information on CVD , aspirin, and statin drug use.

After adjustment for interindividual cardiovascular risk factors, multivariate logistic regression analysis was used to compare CVD odds ratios for each component of aspirin and statin.

As a result of the analysis, the prevalence ratio of combined use of atorvastatin versus single drug use of aspirin was 0.43, lovastatin 0.69, pravastatin 0.44, rosuvastatin 0.34, and simvastatin 0.64, respectively. Rosuvastatin reduced the risk by 66%, which was better than other drugs in terms of effectiveness.

The researchers then conducted a sub-analysis to investigate the protective effects of each statin component on individual CVD events such as congestive heart failure (CHF), coronary heart disease (CHD), angina pectoris, heart attack and stroke.

As a result of the analysis, there was a strong link between the use of aspirin and other statins and the prevalence of individual CVDs such as CHD, CHF, angina pectoris, and heart failure. Rosuvastatin was also ahead with 0.30 and simvastatin 0.98.

Even when variables such as age, sex, diabetes, and body mass index were adjusted, aspirin and rosuvastatin were more effective in preventing cardiovascular disease, but atorvastatin and aspirin were more effective in preventing CVD in the non-hypertensive group .

The research team concluded, “Through this study, we confirmed that the combination of aspirin and a statin is more effective than aspirin alone in preventing CVD. In particular, it was found that rosuvastatin is the combination drug that most effectively reduce CVD events.

“Each statin component has a different profile of benefits and side effects,” he said. “The fact that rosuvastatin is the most effective in reducing total cholesterol and low density lipoprotein cholesterol and increases HDL-C more than atorvastatin is the background of the combination effect. it could have done,” he said.

In this regard, an official from the Society of Endocrinology said, “Aspirin causes bleeding, and statins cause muscle and diabetes side effects, so the benefits and side effects are clear.” There is serious research to find out,” he added.