Statin efficacy varies widely from patient to patient

Statin efficacy varies widely from patient-to-patient
Statin efficacy varies widely from patient-to-patient

HealthDay News -- There is considerable interindividual variation in the magnitude of low-density lipoprotein cholesterol (LDL-C), non-high-density lipoprotein cholesterol (non-HDL-C), and apolipoprotein B (apoB) reductions achieved with statin therapy, which affects cardiovascular disease risk, according to researchers.

“Levels of atherogenic lipoproteins achieved with statin therapy are highly variable, but the consequence of this variability for cardiovascular disease risk is not well-documented,” S. Matthijs Boekholdt, MD, PhD, from the Academic Medical Center in Amsterdam, and colleagues reported in the Journal of the American College of Cardiology.

To conduct a meta-analysis using individual patient data from eight randomized controlled statin trials, the investigators used data from 38,153 patients who were allocated to statin therapy, and underwent assessment for conventional lipids and apolipoproteins at baseline and at one-year follow-up.

Of the patients, 5,287 had 6,286 major cardiovascular events during follow-up. Reductions of LDL-C, non-HDL-C, and apoB were subject to large interindividual variability despite a fixed statin dose. More than 40% of those assigned to high-dose statins did not achieve an LDL-C target of <70mg/dL.

The adjust hazard ratios for major cardiovascular events were 0.56, 0.51, and 0.44, respectively, for patients who reached an LDL-C of 75 to <100 mg/dL, 50 to <75 mg/dL, and <50 mg/dL versus LDL-C >175 mg/DL. The findings were similar for non-HDL-C and apoB.

“Patients who achieve very low LDL-C levels have a lower risk for major cardiovascular events than do those achieving moderately low levels,” concluded the researchers.

References

  1. Boekholdt M et al. Journal of the American College of Cardiology. 2014; doi: 10.1016/j.jacc.2014.02.615
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