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"Eye-Popping" Low-Density Lipoprotein Results from Statin Use Reported: Presented at ASHP

By Maury M. Breecher, PhD, MPH

SAN DIEGO, CA -- June 9, 2003 -- Almost three quarters of patients with elevated levels of low-density lipoprotein (LDL) cholesterol reached their goal levels across three risk categories, according to a study from the at the University of New Mexico Health Sciences Centre (UNMHSC), in Albuquerque, New Mexico.

The study by researchers at this large teaching hospital was presented here at the American Society of Health-System Pharmacists annual summer meeting May 31-June 4.

The efficacy of treatment seen in this study was more than double that reported in L-TAP, a large multicenter assessment study, in which 38% of patients achieved target levels recommended by the National Cholesterol Treatment Program-Adult Treatment Panel II (NCEP-ATP II), noted lead author Richard D'Angio, PharmD, a clinical educational consultant with Pfizer, Inc., in New York.

"The results were eye-popping. The medical personnel of this health centre did a superb job of helping their patients meet their cholesterol-lowering goals, especially in light of the L-Tap results," said Dr. D'Angio.

"Even though other studies demonstrate that very few patients in clinical practice get to goal [levels], that was not the case here," said Dr. D'Angio. "Most of the patients in this study got to their goals. In fact, about 78% of them reached their goals."

The study was a 14-month retrospective study of 332 patients who were being treated by statin monotherapy between April 1, 1999 and June 30 2000 for either coronary heart disease (CHD), two or more CHD risk factors, or a single risk factor. A total of 83% of the cohort had two or more risk factors or known CHD.

Treatment drugs included high potency and low potency statins -- 58% of patients were on atorvastatin, 38.0% were on lovastatin and 3.6% were on simvastatin.

The percentage of patients achieving LDL cholesterol goals decreased as the level of patient risk increased. "The higher the risk of a heart attack, the harder it is to meet LDL-lowering goals because those goals for decrease of cholesterol are higher," explained Dr. D'Angio.

The ATP II goal for those with CHD is an LDL level below 100 mg/dL, for those with two or more risk factors but no existing CHD it is below 130 mg/dL, and for those with only one risk factor it is below 160 mg/dL.

"Even the majority of people in our study with CHD -- more than 61% -- reached their goals," said D'Angio.

The more potent statin they were on, the better their chance of reaching goal, he added.

"The percent of patients achieving LDL goal was highest with atorvastatin and lowest with lovastatin, concluded the authors who also included Louis Achusim, PharmD, of the Department of Pharmaceutical Services, UNMHSC, and Angela Aldrich, and Michael Dutro, both with Pfizer, Inc., in New York.


[Study title: Attainment of Lipid Goals with Statins at an Academic Healthcare Setting.]

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