Achievement of LDL-C goals depends on baseline LDL-C and choice and dose of statin: An analysis from the VOYAGER database

• Background Reducing low-density lipoprotein cholesterol (LDL-C) levels decreases cardiovascular risk in direct proportion to the decrease in LDL-C. Design The aim of this study was to assess the importance of baseline LDL-C and choice and dose of statin in achievement of LDL-C goals of 100 and 70mg/dl, using a novel statistical model. The analysis included 30,102 patient exposures to rosuvastatin 10-40mg or atorvastatin 10-80mg from 31 direct comparative trials in the VOYAGER database. Methods For each statin dose, percentage goal achievement was plotted for 20 equally large subgroups defined by baseline LDL-C. Logistic regression analysis was then performed for each statin dose to estimate the percentage of patients reaching target. Best-fit logistic regression curves were plotted pair-wise', comparing each rosuvastatin dose with equal or higher doses of atorvastatin. Results LDL-C <100mg/dl was achieved by 53.7-85.5% of patients on rosuvastatin 10-40mg and 43.3-80.0% of those on atorvastatin 10-80mg, whereas LDL-C <70mg/dl was achieved by 4.5-44.0% of rosuvastatin-treated patients and 6.5-41.4% of those on atorvastatin. Similar differences in efficacy favouring rosuvastatin over equal or double doses of atorvastatin were observed across the range of baseline LDL-C levels for both LDL-C goals, being more pronounced at higher baseline values. Conclusions Baseline LDL-C and choice and dose of statin are important for LDL-C goal achievement. The present analysis may allow prediction of individual patient response to different statins at different doses.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

MEDICIN OCH HÄLSOVETENSKAP  -- Medicinska och farmaceutiska grundvetenskaper -- Farmaceutiska vetenskaper (hsv//swe)

MEDICAL AND HEALTH SCIENCES  -- Basic Medicine -- Pharmaceutical Sciences (hsv//eng)

Nyckelord

Low-density lipoprotein cholesterol

LDL-C

treatment goals

rosuvastatin

atorvastatin

CORONARY-HEART-DISEASE

RANDOMIZED-TRIALS

CLINICAL-PRACTICE

CHOLESTEROL

ROSUVASTATIN

EFFICACY

ATORVASTATIN

METAANALYSIS

RISK

GUIDELINES

Publikations- och innehållstyp

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