Predictors of early response to high-dose lipid-lowering treatment in high cardiovascular risk patients

Aim

To investigate the efficacy and predictors of attainment of target LDL-C during short-term high-dose statin therapy (atorvastatin 80 mg/day) in patients with high cardiovascular risk.

Material and methods

We evaluated efficacy and safety of one-month of high-dose statin therapy (atorvastatin 80 mg/day) in 187 patients (120 male, 60.8±8.6 years of age) with a history of cardiovascular disease and fasting low-density lipoprotein cholesterol (LDL-C) >1.8 mmol/l or non-highdensity lipoprotein cholesterol (non-HDL-C) >2.6 mmol/l.

Results

At one month target LDL-C level <1.8 mmol/L and target non-HDL-C <2.6 mmol/L were achieved in 76 patients (40.6%) and 81 patients (43.3%), respectively, and both targets were achieved in 36 patients (19.2%). There were no signs of muscle or liver injury. Multivariate logistic regression analysis revealed the following independent predictors of LDL-C goal attainment: baseline LDL-C (OR=0.042, 95% CI 0.005-0.363), baseline TC (OR=0.053, 95% CI 0.0100.294) and baseline non-HDL-C (OR=0.0853, 95% CI 0.0150.434).

Conclusion

Short term high-dose statin therapy is welltolerated, but effective only in 40.6% of high cardiovascular risk patients. Baseline LDL-C may be a predictor of early response in this patient population. Lower baseline LDL-C was associated with attainment of target LDL-C.

Key words

Statins, intensive statin therapy, efficacy, atorvastatin.