Achieving and maintaining national cholesterol education program low-density lipoprotein cholesterol goals with five statins

Andrews, Thomas C.; Ballantyne, Christie M.; Hsia, Judith; Kramer, Jeffrey

doi:10.1016/s0002-9343(01)00799-9

Cited by 161 publications

(88 citation statements)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…3 Even fewer patients in the highest-risk category of CHD can achieve the ATP goal of LDL-C Ͻ100 mg/dL: 6% to 43% of patients with CHD in ACCESS, 3 and 1% to 32% of patients with documented atherosclerosis receiving starting doses of atorvastatin, fluvastatin, lovastatin, or simvastatin. 18 In ATP III, this highest-risk category has been expanded to include individuals with noncoronary atherosclerosis, diabetes mellitus, and multiple risk factors conferring 10-year CHD risk Ͼ20%, doubling the number of individuals with this difficultto-attain LDL-C goal.…”

Section: Discussionmentioning

confidence: 99%

“…2 Statin doses often are not titrated to achieve goals. 2 In the Atorvastatin Comparative Cholesterol Efficacy and Safety Study (AC-CESS), 3 only 43% of patients with coronary heart disease (CHD) receiving the initial dose of atorvastatin and even fewer patients receiving initial doses of other statins achieved ATP II goals.…”

mentioning

confidence: 99%

“…At maximum titration (up to 80 mg), 72% of patients with CHD receiving atorvastatin in ACCESS achieved the ATP II goal, 3 but atorvastatin at maximum dosage has been associated with increased incidence of elevated liver enzymes. 4 Hepatotoxicity and myalgias have also been reported with high doses of other statins.…”

mentioning

confidence: 99%

See 2 more Smart Citations

Effect of Ezetimibe Coadministered With Atorvastatin in 628 Patients With Primary Hypercholesterolemia

et al. 2003

View full text Add to dashboard Cite

Background-Despite the established efficacy of statins, many patients do not achieve recommended LDL cholesterol (LDL-C) goals. Contributing factors may be inadequate dosing, increased risk for adverse effects with high-dose monotherapy, and increased potential for intolerance and adverse effects with combinations of available agents. Methods and Results-In a double-blind study, 628 patients with baseline LDL-C 145 to 250 mg/dL and triglycerides Յ350 mg/dL were randomly assigned to receive 1 of the following for 12 weeks: ezetimibe ( Coadministration of ezetimibe provided a significant additional 12% LDL-C reduction, 3% HDL-C increase, 8% triglyceride reduction, and 10% hs-CRP reduction versus atorvastatin alone. Ezetimibe plus atorvastatin provided LDL-C reductions of 50% to 60%, triglyceride reductions of 30% to 40%, and HDL-C increases of 5% to 9%, depending on atorvastatin dose. LDL-C reductions with ezetimibe plus 10 mg atorvastatin (50%) and 80 mg atorvastatin alone (51%) were similar. Conclusions-Ezetimibe plus atorvastatin was well tolerated, with a safety profile similar to atorvastatin alone and to placebo. When coadministered with atorvastatin, ezetimibe provided significant incremental reductions in LDL-C and triglycerides and increases in HDL-C. Coadministration of ezetimibe and atorvastatin offers a well-tolerated and highly efficacious new treatment option for patients with hypercholesterolemia. (Circulation. 2003;107:2409-2415.)

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

See 1 more Smart Citation

Effect of Ezetimibe Coadministered With Atorvastatin in 628 Patients With Primary Hypercholesterolemia

et al. 2003

View full text Add to dashboard Cite

show abstract

“…Tailoring the starting dose according to individual LDL-C reduction requirements may aid in the achievement of target LDL-C levels [12,15]. There is evidence to suggest that baseline LDL-C levels impact overall LDL-C reduction, [16][17][18] and that treatment with intensive lipid lowering therapy results in greater reductions in LDL-C and a higher proportion of subjects achieving targets compared with more moderate regimens [19][20][21][22][23][24][25][26][27][28][29]. Thus, selecting an initial starting dose calculated to achieve the required LDL-C reduction, may allow more patients to reach targets more quickly, reducing the need for dose increases, thus improving clinical outcomes and being more cost-effective in the long term [30,31].…”

Section: Introductionmentioning

confidence: 99%

Effect of individualizing starting doses of a statin according to baseline LDL-cholesterol levels on achieving cholesterol targets: The Achieve Cholesterol Targets Fast with Atorvastatin Stratified Titration (ACTFAST) study

et al. 2007

View full text Add to dashboard Cite

Aims: To investigate whether selecting the starting dose of atorvastatin according to baseline and target (<2.6 mmol/L) LDL-cholesterol (LDL-C) values would allow high-risk subjects to achieve target LDL-C concentration within 12 weeks, with the initial dose or a single uptitration. Methods and results: Twelve-week, prospective, open-label trial that enrolled 2117 high-risk subjects (statin-free [SF] or statin-treated [ST]). Subjects with LDL-C >2.6 mmol/L (100 mg/dL) but ≤5.7 mmol/L (220 mg/dL) were assigned a starting dose of atorvastatin (10, 20, 40 or 80 mg/day) based on LDL-C and status of statin use at baseline, with a single uptitration at 6 weeks, if required. There was no washout for ST subjects. At study end, 80% of SF (82%, 82%, 83% and 72% with 10, 20, 40 and 80 mg, respectively) and 59% of ST (60%, 61% and 51% with 20, 40 and 80 mg, respectively) subjects reached LDL-C target. In the ST group, an additional 21-41% reduction in LDL-C was observed over the statin used at baseline. Atorvastatin was well tolerated. Conclusion: This study confirms that individualizing the starting dose of atorvastatin according to baseline and target LDL-C values (i.e. the required LDL-C reduction), allows a large majority of high-risk subjects to achieve target safely, within 12 weeks, with the initial dose or with a single titration.

show abstract

“…The most efficient LDL levels lowering are inhibitors of HMG-CoA reductase (3-hydroxy-3-methyl-glutaryl-coenzyme A) which are called "statins". 4 Lovastatin, Atorvastatin, Fluvastatin, Pravastatin and Ruvastatin belong to this group. Atorvastatin is the most powerful statin drug class that can be administered at a dose of 10-80 mg per day.…”

Section: Introductionmentioning

confidence: 97%

The effect of statins on carotid intima-media thickness in patients with acute coronary syndrome

2017

View full text Add to dashboard Cite

Background: Statins have been established by definitive primary and secondary cardiovascular prevention trials as the cornerstone of pharmacy prevention of atherosclerotic vascular disease. Carotid arterial intima-media thickness is used as a noninvasive surrogate end point in epidemiologic studies and clinical trials to gauge progression and regression of atherosclerosis. In this trial, we compared the effects of a high-potency statin with different dose (atorvastatin 20 mg/d and atorvastatin 40 mg/d) on carotid intima-media thickness (CIMT).Methods: This was a randomized, single blinded clinical trial that performed on 100 patients with ACS diagnosis from April 2014 to September 2015. The effects of atorvastatin (20 mg/d; n=50) and atorvastatin (40 mg/d; n=50) on CIMT were compared using serial assessment of the thickness of common carotid artery. Results: The mean patient age was 52 years and 74% were male. Baseline CIMT and other characteristics were similar between study groups. CIMT was stable in the both study groups after 6 months and there were no meaningful statistical differences observed between study groups (change in CIMT, 0.044±0.169 and -0.006±0.168 mm; p=0.14).Conclusions: This comparative trial shows that the use of atorvastatin 20 mg/d and 40 mg/d in short term have similar effects on carotid intima-media thickness. However, intensive statin therapy may have been shown to yield improvement in atherosclerosis with measurement of the carotid intima-media thickness.

show abstract

Achieving and maintaining national cholesterol education program low-density lipoprotein cholesterol goals with five statins

Cited by 161 publications

References 12 publications

Effect of Ezetimibe Coadministered With Atorvastatin in 628 Patients With Primary Hypercholesterolemia

Effect of Ezetimibe Coadministered With Atorvastatin in 628 Patients With Primary Hypercholesterolemia

Effect of individualizing starting doses of a statin according to baseline LDL-cholesterol levels on achieving cholesterol targets: The Achieve Cholesterol Targets Fast with Atorvastatin Stratified Titration (ACTFAST) study

The effect of statins on carotid intima-media thickness in patients with acute coronary syndrome

Contact Info

Product

Resources

About