The European Society of Cardiology
Reducing low-density lipoprotein cholesterol – treating to target and meeting new European goals
University of Sydney, Sydney, NSW, Australia
* Correspondence: Len Kritharides, PhD, FRACP, FAHA, The Department of Cardiology, 3rd Floor Multi-Building, Concord Hospital, Hospital Road, Concord, Sydney, NSW 2319, Australia. Tel.: +61-29767-6296; fax: +61-29767-6994
l.kritharides{at}unsw.edu.au
Abstract
Many hypercholesterolaemic patients fail to achieve target low-density lipoprotein cholesterol (LDL-C) levels in clinical practice. In part, this failure is related to inadequate efficacy of commonly used statins in reducing LDL-C and to difficulties inherent in dose titration. The availability of statins that produce large decreases in LDL-C at starting doses could significantly improve treatment of patients by facilitating achievement of LDL-C goals. The multi-national MERCURY I trial has shown that rosuvastatin at its starting 10-mg dose enables more patients to reach target LDL-C levels and reduces LDL-C more than starting or higher doses of other commonly used statins. In addition, post hoc analyses of data from trials comparing rosuvastatin with atorvastatin, simvastatin and pravastatin indicate that rosuvastatin enables more hypercholesterolaemic patients to reach the newly published LDL-C goals in the Third Joint Task Force European guidelines, including the most aggressive goals, than do other statins at starting doses and across dose ranges. Improved goal achievement at starting doses, as well as the concomitant greater reduction in LDL-C, may constitute an important advantage in clinical practice.
Key Words: Coronary heart disease • Low-density lipoprotein cholesterol • Statins • Mercury I • Joint Task Force European guidelines • Hypercholesterolaemia