Large variation in lipid reduction with high-dose statin tx

(HealthDay)—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 a study published in the August 5 issue of the Journal of the American College of Cardiology.

S. Matthijs Boekholdt, M.D., Ph.D., from the Academic Medical Center in Amsterdam, and colleagues conducted a meta-analysis using individual patient data from eight randomized controlled statin trials. Data were included for 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.

The researchers found that 5,287 participants 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 percent of those assigned to high-dose statins did not achieve an LDL-C target of <70 mg/dL. The adjusted hazard ratios for major cardiovascular events were 0.56, 0.51, and 0.44, respectively, for those 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," conclude the authors.

Several authors disclosed financial ties to the pharmaceutical industry.