Björn W Karlson1, Olov Wiklund2, Michael K Palmer3, Stephen J Nicholls4, Pia Lundman5, Philip J Barter6. 1. AstraZeneca Gothenburg, Pepparedsleden 1, Mölndal SE-431 83, Sweden Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg SE-413 45, Sweden bjorn.w.karlson@astrazeneca.com. 2. Department of Molecular and Clinical Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg SE-413 45, Sweden. 3. School of Healthcare Science, Manchester Metropolitan University, Manchester, UK. 4. South Australian Health and Medical Research Institute, University of Adelaide, Adelaide, Australia. 5. Danderyd Hospital, Karolinska Institutet, Stockholm, Sweden. 6. Centre for Vascular Research, University of New South Wales, Sydney, Australia.
Abstract
AIMS: Patient response to statin treatment is individual and varied. As a consequence, when using a specific-dose approach, as recommended in the 2013 American College of Cardiology/American Heart Association guideline, there will be a range of reductions in the concentration of low-density lipoprotein cholesterol (LDL-C). The aim of this study was to use individual patient data from the VOYAGER meta-analysis to determine the extent of the variability in LDL-C reduction in response to treatment across the recommended doses of different statins. METHODS AND RESULTS: The percentage change from baseline in LDL-C was calculated using individual subject data collected from 32 258 patients treated with atorvastatin 10-80 mg, rosuvastatin 5-40 mg, or simvastatin 10-80 mg. The percentage change in LDL-C for each patient was then used to generate waterfall plots that demonstrated the extent of the variability in response to treatment at all doses of the three statins. The standard deviation of LDL-C reduction for all statins and doses ranged from 12.8 to 17.9%. The percentage of patients experiencing a suboptimal response (<30% reduction in LDL-C) ranged from 5.3 to 53.3%. CONCLUSION: These results indicate that there is considerable individual variation in the LDL-C reduction at all doses of simvastatin, atorvastatin, and rosuvastatin. Published on behalf of the European Society of Cardiology. All rights reserved.
AIMS: Patient response to statin treatment is individual and varied. As a consequence, when using a specific-dose approach, as recommended in the 2013 American College of Cardiology/American Heart Association guideline, there will be a range of reductions in the concentration of low-density lipoprotein cholesterol (LDL-C). The aim of this study was to use individual patient data from the VOYAGER meta-analysis to determine the extent of the variability in LDL-C reduction in response to treatment across the recommended doses of different statins. METHODS AND RESULTS: The percentage change from baseline in LDL-C was calculated using individual subject data collected from 32 258 patients treated with atorvastatin 10-80 mg, rosuvastatin 5-40 mg, or simvastatin 10-80 mg. The percentage change in LDL-C for each patient was then used to generate waterfall plots that demonstrated the extent of the variability in response to treatment at all doses of the three statins. The standard deviation of LDL-C reduction for all statins and doses ranged from 12.8 to 17.9%. The percentage of patients experiencing a suboptimal response (<30% reduction in LDL-C) ranged from 5.3 to 53.3%. CONCLUSION: These results indicate that there is considerable individual variation in the LDL-C reduction at all doses of simvastatin, atorvastatin, and rosuvastatin. Published on behalf of the European Society of Cardiology. All rights reserved.
Authors: Tomasz Wilmanski; Sergey A Kornilov; Christian Diener; Matthew P Conomos; Jennifer C Lovejoy; Paola Sebastiani; Eric S Orwoll; Leroy Hood; Nathan D Price; Noa Rappaport; Andrew T Magis; Sean M Gibbons Journal: Med (N Y) Date: 2022-05-11
Authors: Christopher P Cannon; Irfan Khan; Alexa C Klimchak; Matthew R Reynolds; Robert J Sanchez; William J Sasiela Journal: JAMA Cardiol Date: 2017-09-01 Impact factor: 14.676