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

Mike K. Palmer, Stephen J. Nicholls, Pia Lundman, Philip J. Barter, Björn W. Karlson

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

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 70 mg/dl, using a novel statistical model. The analysis included 30,102 patient exposures to rosuvastatin 10-40 mg or atorvastatin 10-80 mg 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 100 mg/dl was achieved by 53.7-85.5% of patients on rosuvastatin 10-40 mg and 43.3-80.0% of those on atorvastatin 10-80 mg, whereas LDL-C 70 mg/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.

Original languageEnglish
Pages (from-to)1080-1087
Number of pages8
JournalEuropean Journal of Preventive Cardiology
Volume20
Issue number6
DOIs
Publication statusPublished - 1 Dec 2013

Keywords

  • LDL-C
  • Low-density lipoprotein cholesterol
  • atorvastatin
  • rosuvastatin
  • treatment goals

ASJC Scopus subject areas

  • Epidemiology
  • Cardiology and Cardiovascular Medicine

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