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https://hdl.handle.net/2440/85574
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Type: | Journal article |
Title: | Achievement of 2011 European low-density lipoprotein cholesterol (LDL-C) goals of either <70 mg/dl or ≥50% reduction in high-risk patients: results from VOYAGER |
Other Titles: | Achievement of 2011 European low-density lipoprotein cholesterol (LDL-C) goals of either <70 mg/dl or >/-50% reduction in high-risk patients: results from VOYAGER |
Author: | Karlson, B. Nicholls, S. Lundman, P. Palmer, M. Barter, P. |
Citation: | Atherosclerosis, 2013; 228(1):265-269 |
Publisher: | Elsevier Science Ireland |
Issue Date: | 2013 |
ISSN: | 0021-9150 1879-1484 |
Statement of Responsibility: | Björn W. Karlson, Stephen J. Nicholls, Pia Lundman, Mike K. Palmer, Philip J. Barter |
Abstract: | <h4>Objective</h4>Guidelines published in 2011 by the European Atherosclerosis Society and the European Society of Cardiology recommend a goal of either low-density lipoprotein cholesterol (LDL-C) <70 mg/dl (~1.8 mmol/l) or ≥ 50% reduction in LDL-C for patients at very high cardiovascular risk. The aim of this study was to determine the percentage of high-risk patients from the VOYAGER individual patient data meta-analysis treated with rosuvastatin 10-40 mg, atorvastatin 10-80 mg or simvastatin 10-80 mg who achieved this goal.<h4>Methods</h4>We analysed 25,075 patient exposures from high-risk patients. Paired comparisons were made between each rosuvastatin dose and an equal or higher dose of either atorvastatin or simvastatin, with a series of meta-analyses that included only randomised studies that directly compared rosuvastatin and its comparator treatments.<h4>Results</h4>As statin dose increased, higher percentages of patients achieved LDL-C <70 mg/dl or ≥ 50% LDL-C reduction. A greater percentage achieved this goal with rosuvastatin 10-40 mg (43.8-79.0%) than with equal or double milligram doses of atorvastatin (16.1-65.2%) or simvastatin (0-39.7%). Paired comparisons showed statistically significant differences for: rosuvastatin 10 mg vs. atorvastatin 10-20 mg and simvastatin 10-20 mg; rosuvastatin 20 mg vs. atorvastatin 20-40 mg and simvastatin 20-80 mg; and rosuvastatin 40 mg vs. atorvastatin 40-80 mg and simvastatin 40-80 mg (all p < 0.001).<h4>Conclusion</h4>These data from VOYAGER highlight the importance of an effective statin at an appropriate dose to achieve treatment goals for LDL-C in patients with very high cardiovascular risk. |
Keywords: | Low-density lipoprotein cholesterol; meta-analysis; rosuvastatin; atorvastatin; simvastatin; guidelines; targets |
Rights: | © 2013 Elsevier Ireland Ltd. All rights reserved. |
DOI: | 10.1016/j.atherosclerosis.2013.02.027 |
Published version: | http://dx.doi.org/10.1016/j.atherosclerosis.2013.02.027 |
Appears in Collections: | Aurora harvest 2 Medicine publications |
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