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High-dose statins, compared with lower doses, can prevent adverse vascular events but also are associated with side effects (e.g., myalgia and myositis, transaminitis, diabetes). To develop and test a clinical prediction rule for identifying patients with stable angina who would benefit most from intensive statin therapy, investigators analyzed two industry-sponsored trials in which 80 mg of atorvastatin was compared with lower-dose statin therapy (10-mg atorvastatin or 20–40-mg simvastatin).
Using data from one trial (10,000 patients), they identified 13 clinical factors that predicted 5-year event rates. In the second trial (which involved 9000 similar patients), applying the derived rule led to moderate discrimination of patients who suff…