COMPARING HIGH INTENSITY WITH LOW INTENSITY STATINS IN ACHIEVING OPTIMAL LDL GOALS AMONG CORONARY ARTERY DISEASE PATIENTS IN SUBURBAN POPULATION IN SOUTH INDIA.

Corresponding Author:
Ramesh Sankaran,
Associate Professor, Department of Cardiology,
Sriramachandra Institute of Higher Education and Research
(Deemed to be University),
Chennai,
Tamilnadu, India.
E-mail: sankaran_ramesh2000@yahoo.co.in

ABSTRACT

BACKGROUND

Patients with ischemic heart disease (IHD), including those with an acute coronary syndrome (ACS), should receive long-term, intensive lipid-lowering statin therapy. Target levels of low-density lipoprotein cholesterol (LDL-C) in patients with ACS are <70 mg/dl. Various studies have demonstrated that many high-risk patients do not achieve optimal LDL-C control in spite of being on adequate dose of lipid-lowering statin therapy. The aim of the present study was to analyse the control of LDL-C and high-density lipoprotein (HDL-C) levels after 12 weeks of statin therapy at different doses, in patients who had ACS and who underwent revascularization with or without a prior episode of ACS.

MATERIALS AND METHODS

This was a prospective cohort study. 100 consecutive cases diagnosed with ACS or those who underwent coronary intervention with or without prior ACS were enrolled. These patients were initiated on either atorvastatin (ATV; doses ranging from 10 mg to 80 mg) or rosuvastatin (RSV; 5 mg to 20 mg), according to initial LDL-C values at index point of contact. Continuous Variables are presented as mean ± SD and were compared using one-way ANOVA. Comparison of each class of patients according to the respective doses of statins and the degree of lowering of LDL-C after 12 weeks of treatment was done.

RESULTS

Majority of patients were male (80%). ATV40 demonstrated significant change in LDL-C, HDL-C and TC. ATV20 produced significant change in both LDL-C and TC, while ATV10 demonstrated significant change only in TC. Furthermore, only 69% of the people received high-dose of statin. More than 80% of the patients using high-dose stains (i.e., ATV40, ATV80 and RSV20) achieved optimal LDL-C control. In patients taking low-dose statin, more than 50% people did not achieve optimal LDL-C control.

CONCLUSION

Patients with CAD who were not receiving adequate dose of lipid lowering statin therapy, did not achieve optimal LDL-C control. Among these, patients treated with high-dose statins (ATV40, ATV80 and RSV20) achieved optimal LDL-C control and patients who received low-doses of statins did not acquire optimal LDL control and thus are further prone to adverse coronary events.

KEY WORDS

Acute Coronary Syndrome, Atorvastatin, High-Dose Statin, Rosuvastatin.