Journal List > J Lipid Atheroscler > v.3(1) > 1059540

Kwon, Kim, Hyun, Won, Shin, Lee, Kim, Kim, and Kim: Cholesterol Lowering Effects of Low-dose Statins in Korean Patients

Abstract

Objective

The aim of this study is to compare cholesterol lowering effects of low dose 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) in Korean patients.

Methods

A total of 909 consecutive patients were enrolled prospectively according to the criteria of National Cholesterol Education Program guidelines. Lipid profiles were obtained before and 2 months after statin therapy.

Results

Atorvastatin 10 mg (n=260), lovastatin 20 mg (n=145), pitavastatin 2 mg (n=80), pravastatin 20 mg (n=28), rosuvastatin 5 mg (n=145), and simvastatin 20 mg (n=208) reduced low density lipoprotein (LDL) cholesterol by -41.8±11.0%, -33.8±12.8%, -39.3±10.8%, -31.5±8.9%, -48.8±12.3%, and -42.8±13.5%, respectively. LDL cholesterol less than 130 mg/dL was achieved in 90.3%, 76.9%, 88.5%, 85.2%, 97.2%, and 94.2%, respectively. The reduction of LDL cholesterol by 30% or more was obtained in 84.4%, 60.7%, 81.6%, 63.0%, 93.0%, and 83.5%, respectively. LDL cholesterol less than 70 mg/dL or the reduction by 50% or more was observed in a small portion of patients and was variable according to the different types of statins.

Conclusion

A low dose statin was enough to manage dyslipidemia in most Korean patients with low to moderate risks and was even effective in a subpopulation of high risk patients.

Figures and Tables

Table 1
Comparisons of baseline clinical and laboratory characteristics among statin groups
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Data are presented as the Mean±SD, BMI; body mass index, HDL-C; high density lipoprotein cholesterol, LDL-C; low density lipoprotein cholesterol, AST; aspartate aminotransferase, ALT; alanine aminotransferase

Table 2
Percent changes of lipid profiles among statin groups
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Data are presented as the Mean±SD, *; p<0.05, HDL-C; high density lipoprotein cholesterol, LDL-C; low density lipoprotein cholesterol

Table 3
Parameters associated with percent changes of lipid profiles
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HDL-C; high density lipoprotein cholesterol, LDL-C; low density lipoprotein cholesterol, BMI; body mass index, AST; aspartate aminotransferase, ALT; alanine aminotransferase

Table 4
Percent of patients achieving LDL-C targets recommended by major guidelines for lipid management among statin groups
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HDL-C; high density lipoprotein cholesterol, LDL-C; low density lipoprotein cholesterol

References

1. Baigent C, Keech A, Kearney PM, Blackwell L, Buck G, Pollicino C, et al. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005; 366:1267–1278.
crossref
2. Kim CJ, Lee KJ. Hypercholesterolemia; management of Korean patients in new millennium. Korean J Med. 2007; 72:580–592.
3. Kim CJ. In the shadow of the "Statin Festival". Korean Circ J. 2006; 36:77–83.
crossref
4. Jones P, Kafonek S, Laurora I, Hunninghake D. Comparative dose efficacy study of atorvastatin versus simvastatin, pravastatin, lovastatin, and fluvastatin in patients with hypercholesterolemia (the CURVES study). Am J Cardiol. 1998; 81:582–587.
crossref
5. Jones PH, Davidson MH, Stein EA, Bays HE, McKenney JM, Miller E, et al. Comparison of the efficacy and safety of rosuvastatin versus atorvastatin, simvastatin, and pravastatin across doses (STELLAR* Trial). Am J Cardiol. 2003; 92:152–160.
crossref
6. Lee E, Ryan S, Birmingham B, Zalikowski J, March R, Ambrose H, et al. Rosuvastatin pharmacokinetics and pharmacogenetics in white and Asian subjects residing in the same environment. Clin Pharmacol Ther. 2005; 78:330–341.
crossref
7. Downs JR, Clearfield M, Weis S, Whitney E, Shapiro DR, Beere PA, et al. Primary prevention of acute coronary events with lovastatin in men and women with average cholesterol levels: results of AFCAPS/TexCAPS. Air Force/Texas Coronary Atherosclerosis Prevention Study. JAMA. 1998; 279:1615–1622.
crossref
8. Shepherd J, Cobbe SM, Ford I, Isles CG, Lorimer AR, MacFarlane PW, et al. Prevention of coronary heart disease with pravastatin in men with hypercholesterolemia. West of Scotland Coronary Prevention Study Group. N Engl J Med. 1995; 333:1301–1307.
crossref
9. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease: the Scandinavian Simvastatin Survival Study (4S). Lancet. 1994; 344:1383–1389.
10. Nakamura H, Arakawa K, Itakura H, Kitabatake A, Goto Y, Toyota T, et al. Primary prevention of cardiovascular disease with pravastatin in Japan (MEGA Study): a prospective randomised controlled trial. Lancet. 2006; 368:1155–1163.
crossref
11. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA. 2001; 285:2486–2497.
12. Grundy SM, Cleeman JI, Merz CN, Brewer HB Jr, Clark LT, Hunninghake DB, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III guidelines. Circulation. 2004; 110:227–239.
crossref
13. Cho JH, Kim KJ, Lee WS, Lee KJ, Kim SW, Kim TH, et al. Effect of statins on C-reactive protein, lipoprotein(a) and fibrinogen in hypercholesterolemic patients. J Lipid Atheroscler. 2012; 1:21–28.
crossref
14. Sever PS, Dahlöf B, Poulter NR, Wedel H, Beevers G, Caulfield M, et al. Prevention of coronary and stroke events with atorvastatin in hypertensive patients who have average or lower-than-average cholesterol concentrations, in the Anglo-Scandinavian Cardiac Outcomes Trial--Lipid Lowering Arm (ASCOT-LLA): a multicentre randomised controlled trial. Lancet. 2003; 361:1149–1158.
crossref
15. Ridker PM, Danielson E, Fonseca FA, Genest J, Gotto AM Jr, Kastelein JJ, et al. Rosuvastatin to prevent vascular events in men and women with elevated C-reactive protein. N Engl J Med. 2008; 359:2195–2207.
crossref
16. Eckel RH, Jakicic JM, Ard JD, Hubbard VS, de Jesus JM, Lee IM, et al. 2013 AHA/ACC Guideline on Lifestyle Management to Reduce Cardiovascular Risk: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. Circulation. Forthcoming 2013.
17. Yoo WS, Lee SB, Ahn JH, Kim K, Lee DC, Rhee KJ, et al. Effect of lovastatin(Mevacor(R)) on serum lipids of patients with primary hyperlipidemia. Korean Circ J. 1989; 19:489–496.
crossref
18. Lee WK, Yoon J, Jang YS, Cho SY, Shim WH, Kim SS, et al. The effect of lovastatin(Mevacor(R)) on serum lipids of patients with hypercholesterolemia. Korean Circ J. 1991; 21:567–572.
crossref
19. Lee HJ, Min CH, Choi KS, Ryu WS, Ryoo UH. Effects of lovastatin(Mevacor(R)) on lowering plasma lipids in patients with hyperlipidemia. Korean Circ J. 1991; 21:781–785.
crossref
20. Kim JS, Chai IH, Park SW, Hong SK, Kim HS, Kim CH, et al. Clinical efficacy of lovastatin in patients with hypercholesterolemia. Korean Circ J. 1992; 22:121–129.
crossref
21. Park JH, Ahn YG, Jeong MH, Cho JG, Park JC, Choi KC, et al. A clinical trial of pravastatin in Korean patients with hypercholesterolemia. Korean Circ J. 1992; 22:307–313.
crossref
22. Kim JS, Han KH, Park SW, Bang JK, Hong SK, Sohn DW, et al. Clinical efficacy of pravastatin in patients with hypercholesterolemia. Korean Circ J. 1992; 22:113–120.
crossref
23. Park JW, Ryu KH, Lim CY, Koh YB, Lee Y. Effects of short-term pravastatin therapy in patients with hyperlipidemia. Korean Circ J. 1993; 23:136–141.
crossref
24. Shin HH, Kim KB, Kang JC, Son MS, Kim JH, Kim JS, et al. Korean multicenter clinical trial of simvastatin (KS-1 study). Korean J Med. 1999; 57:906–915.
25. Koh JH, Shin JH, Kim HS, Tahk SJ, Choi BI, Kim D, et al. Efficacy and safety of atorvastatin in patients with hypercholesterolemia. Korean Circ J. 1999; 29:928–936.
crossref
26. Chun KJ, Chung N, Ha JW, Ahn S, Rim SJ, Jang Y, et al. Efficacy and safety of atorvastatin in patients with elevated LDL-cholesterolemia. Korean Circ J. 1999; 29:1309–1316.
crossref
27. Kim CH, Kim KI, Kim JH, Jun JE, Bae JH, Lee JW, et al. Prospective study to evaluate the efficacy and safety of pitavastatin in patients with risk factor of cardiovascular disease(PEACE Study). Korean Circ J. 2007; 37:16–21.
crossref
28. Lee SH, Chung N, Kwan J, Kim DI, Kim WH, Kim CJ, et al. Comparison of the efficacy and tolerability of pitavastatin and atorvastatin: an 8-week, multicenter, randomized, open-label, dose-titration study in Korean patients with hypercholesterolemia. Clin Ther. 2007; 29:2365–2373.
crossref
29. Yun KH, Park HY, Choi JH, Song MJ, Park EM, Kim YK, et al. Comparison of efficacy and safety after administering high potency statin to high risk patients: rosuvastatin 10 mg versus atorvastatin 20 mg. Korean Circ J. 2007; 37:154–160.
crossref
30. Park JS, Kim YJ, Choi JY, Kim YN, Hong TJ, Kim DS, et al. Comparative study of low doses of rosuvastatin and atorvastatin on lipid and glycemic control in patients with metabolic syndrome and hypercholesterolemia. Korean J Intern Med. 2010; 25:27–35.
crossref
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