Eficacia de atorvastatina versus simvastatina en el riesgo de morbimortalidad en pacientes con enfermedad cerebrovascular. Revisión sistemática

Abstract

Cerebrovascular disease encompasses various pathologies, all linked to problems with cerebral blood flow. Among the associated risk factors are elevated cholesterol (low-density lipoprotein - LDL) levels in the bloodstream, and to counteract the effects of cholesterol, atorvastatin and simvastatin have proven to be very efficient drugs. Objective: To assess the efficacy of atorvastatin versus simvastatin in reducing morbidity and mortality risk in patients with cerebrovascular disease. Methodology: A systematic review was conducted on different databases, such as PubMed, SpringerLink, and Elsevier. Defined keywords in English and Spanish were used as descriptors. Boolean operators like AND and OR were employed to combine and exclude terms. Articles in English and Spanish published after 2019 and with full content were included. The screening process was detailed following the PRISMA 2020 model. The articles selected for the results chapter were analyzed for bias using the ROB 2 tool and quality according to the NHLBI tool. Results: Fifty-nine studies were examined, and 19 met the designed objectives for result processing. Both medications demonstrate excellent efficacy in reducing LDL levels in the blood. The main adverse effect was muscle toxicity, mainly reflected in muscle weakness. Doses and treatment duration varied, but simvastatin predominantly showed a daily dose of 40 mg, with higher doses of over 40 mg for atorvastatin. Conclusions: Both drugs demonstrate high efficacy. Muscle weakness was the most common adverse effect. Simvastatin is generally administered in lower doses. Keywords: cholesterol, atherosclerosis, stroke, simvastatin, atorvastatin.