Atorvastatin treatment and LDL cholesterol target attainment in patients at very high cardiovascular risk
Open accessAbstract
The use of atorvastatin is rapidly increasing among statins since the introduction of generics. However, only limited data are available on its current use and the effectiveness outside of randomised trials. The aim of the study was to assess low-density lipoprotein (LDL-C) levels in ambulatory patients at very high cardiovascular risk on atorvastatin therapy in physician's offices. A total of 2625 high-risk patients on atorvastatin were included into this cross-sectional study by 539 office-based physicians between June and December 2014. 47.0 % of the patients had documented coronary heart disease (CHD), 25.1 % type 2 diabetes mellitus (DM), and 27.9 % CHD plus concomitant DM. The mean age was 66.1 ± 10.8 years, 62.1 % were male. Atorvastatin at the dose of 10, 20, 40 and 80 mg/day was administered in 15.6, 45.7, 33.9, and 4.8 % of the patients, respectively. The treatment duration was 92.6 ± 109.6 weeks. The mean atorvastatin dose at therapy start was 24.8 ± 15.2 mg/day and at time of documentation 27.9 ± 15.8 mg/day. Low-density lipoprotein cholesterol (LDL-C) <70 mg/dL was achieved by 10.5 % of the total cohort (7.5 % in DM, 9.3 % in CHD, and 15.2 % in CHD + DM). In contrast, according to physicians' subjective assessment, 62.7 % of patients (with small differences between groups) had reached their individual LDL-C target. In summary, higher doses of atorvastatin are not frequently used in clinical practice. The LDL-C target level <70 mg/dL as recommended by current guidelines is achieved only in a minority of atorvastatin treated patients at very high cardiovascular risk.
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It is unlikely that the increase in HDL-C caused by statins makes a substantial contribution to the reduction of events mediated by statins.
“It is unlikely that this increase in HDL-C makes a substantial contribution to the reduction of events mediated by statins [83–85].”
From HDL cholesterol: reappraisal of its clinical relevance (2017) · cites this paper as [85]
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- Authors
- Laufs, U., Karmann, B., & Pittrow, D.
- Affiliations
- Universitätsklinikum des Saarlandes (DE)
- MSD (Germany) (DE)
- Technische Universität Dresden (DE)
- Corresponding author
- Laufs, Ulrich
- Venue
- Clinical Research in Cardiology
- Published
- 2016-04-27
- Volume
- 105
- Issue
- 9
- Pages
- 783-790
- ISSN
- 1861-0684 (ISSN-L)
- 1861-0692
- PMC
- PMC4989032
- OpenAlex
- W2343722442
- Cited by
- 59
- References
- 37
- Citations by year
- 2026: 5 · 2025: 2 · 2024: 2 · 2023: 6 · 2022: 10 · 2021: 5 · 2020: 9 · 2019: 6 · 2018: 8 · 2017: 6
- FWCI
- 7.39
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Clinical Research in Cardiology (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- Funders
- MSD
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Keywords
- atorvastatin, LDL cholesterol, LDL-C goal attainment, very high cardiovascular risk, statin therapy, coronary artery disease, type 2 diabetes, real-world effectiveness, outpatients
- MeSH terms
- Atorvastatin, Aged, Cardiovascular Diseases, Cross-Sectional Studies, Female, Germany, Humans, Cholesterol, LDL, Male, Middle Aged, Retrospective Studies, Risk Factors, Time Factors, Biomarkers, Treatment Outcome, Practice Guidelines as Topic, Risk Assessment, Hydroxymethylglutaryl-CoA Reductase Inhibitors, Dyslipidemias
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