Dyslipidemia and patient with 1 or less risk factor

Dyslipidemia is increasing of cholesterol level,
triglycerides and low-density lipoprotein (LDL)cholesterol. High-density
lipoprotein (HDL)cholesterol will be maintained at low serum levels. This
imbalance in cholesterol levels known as one of the most risk factors that lead
to atherosclerosis and cardiovascular diseases (CVD)1.  The outcomes of the vascular diseases will be
improved by lowering of LDL cholesterol level. 
The patient with cardiovascular diseases should keep their LDL level
below 100 mgdl, Patients with 2 or more risk factor of cardiovascular diseases
level of LDL must be less than 130 mgdl and patient with 1 or less risk factor
the level of LDL should be less than 160 mgdl2.

Statins which may know as HMG CoA reductase are used to help
lowering the risk of cardiovascular disease (CVD) by controlling the serum
lipid levels3.The Generic drug should contain the same basic content as the
brand name product, in terms of pharmacological properties.Generic
manufacturers do not need to repeat the pre-clinical and clinical testing.
There should be no difference in the absorption coefficient between the Generic
drug and the brand name drug to be bioequivalent4. The effect of recommended
dose of  Simvastatin will reduce the LDL
level from 18% to 41%.The effect of newly Statin which is known atorvastatin at
dose range between 10 to 80 mg will reduce LDL level from 35% to 61%2. US and
European Authorities don’t recommend specific statins for  CVD management guidelines and some nationally
do recommend. For example the recommended guideline for management  Cardiovascular Risk in Dutch is simvastatin
40 mg and pravastatin 40 mg and in the UK the National Institute for
Therapeutics and Clinical Excellence (NICE) recommends starting therapy with 40
mg daily simvastatin and the recommended Guideline in the Netherlands Require
the patients to be at very high risk of CVD or the preferred statins do not
achieve the recommended goal to use more potent statins (atorvastatin or
rosuvastatin)3.

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in new Zealand, a study took place with 126 adult Patients
with atherosclerotic disease this study Was established when switching from
simvastatin to less potent fluvastatin due to economic issues. the result
showed that the level of cholesterol increase significantly in 94 % of the
population and the thrombotic vascular event increased three-fold in comparison
between the six-month period before and after the switching. A secondary care
study in the UK audited patients with acute coronary syndromes to
cardiovascular consequence. in 2005 a group of 100 wear gave atorvastatin 40–80
mg for the treatment of MI or unstable angina and in 2006 a second group of 121
patients was treated with simvastatin 40 mg dose. the result during follow-up
from three to six months period revealed the mortality increased significantly
(17% versus 5%) and the cardiac re-admissions was also significantly
increased  (53 versus 33) in the group
treated with simvastatin in compared with the group who is treated by
atorvastatin5.

We investigate the potential outcome of using Rosuvastatin
in terms of LDL controlling level and compare it with atorvastatin To explore the impact of changing statins from brand to generic products
on the level of LDL in patients with hyperlipidemia in National Guard Hospital
in Riyadh.1.    To determine the
level of LDL in patients receiving Lipitor and atorvastatin.

2.    To determine the
level of LDL in patients receiving Crestor and generic rousvastatin.To examine statin adverse events in patients receiving
generic statin To estimate the
prevalence of uncontrolled LDL levels in high risk patients.  Study will take place in King Abdulaziz Cardiac Center, National Guard Hospital in Riyadh , KSA.Inclusion: Adult patients (³ 18 years)  who use either rosuvastatin or atorvastatin
between January 2015 and Septemeber 2017

 Exclusion : Patients on simvastatin , Patients not on any
statin

  Retrospective chart review.  All patients meeting the
inclusion criteria will be included.All patients meeting the inclusion criteria will be included using
random sampling technique.  Please see data
collection sheet. Data Cleaning:Raw data will be processed in accordance with the best
practices for data management to identify any inaccuracies or incompleteness in
advance to the statistical analysis. In order to accomplish this task, all
interval variables will be summarized in terms of minimum and maximum values.
Those values will be checked and compared against the possible minimum and
maximum value of each variable and variables with implausible values will be
flagged.  A similar process will be
applied to categorical variables to identify any potential anomalies
(miscodes…) by running a general frequency analysis.

Data management and analyses:

Data management and analysis will be achieved using SPSS
21.0 Release 21.0.0.0, IBM, USA.. Descriptive statistical analyses will be
performed for the study sample. Continuous variables will be summarized as mean
(SD), median (interquartile range, IQR). Proportions and percentages will be
used for categorical variables. Interferential statistics will be carried out
using Chi-square test to compare frequencies with 95% CI. Statistical
significance will be considered at p

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