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LDL cholesterol goals and cardiovascular risk during statin treatment: the IDEAL study
Linköping University, Department of Medical and Health Sciences, Internal Medicine. Linköping University, Faculty of Health Sciences. Östergötlands Läns Landsting, Heart and Medicine Centre, Department of Endocrinology and Gastroenterology UHL.
Pfizer Sweden.
Oslo University Hospital.
Pfizer Inc.
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2011 (English)In: EUROPEAN JOURNAL OF CARDIOVASCULAR PREVENTION and REHABILITATION, ISSN 1741-8267, Vol. 18, no 2, 262-269 p.Article in journal (Refereed) Published
Abstract [en]

Aims: We assessed the proportion of patients treated with either simvastatin 20 or 40 mg or atorvastatin 80 mg who achieved low-density lipoprotein cholesterol (LDL-C) goals of 2.5 or 2.0 mmol/l in the Incremental Decrease in End Points Through Aggressive Lipid Lowering (IDEAL) study. We explored how lipoprotein components related to cardiovascular disease (CVD) outcomes in these groups. Methods and results: For subjects who reached on-treatment LDL-C goals, Cox regression models were used to assess the ability of lipoprotein components to predict CVD events. Treatment with simvastatin or atorvastatin resulted in 40 per cent and 80 per cent of patients, respectively, reaching the 2.5 mmol/l goal and 12 per cent and 52 per cent, respectively, reaching the 2.0 mmol/l goal, after 1 year (all p andlt; 0.001 between groups). Adjusting for baseline LDL-C levels, hazard ratio (HR) for those reaching 2.0-2.5 mmol/l LDL-C versus those reaching andlt; 2.0 mmol/l was 1.16 (95% confidence interval [CI], 1.02-1.33, p = 0.023). An increase of the apolipoprotein B/A1 (apoB/A1) ratio by 1 standard deviation in participants who reached 2.0 mmol/l showed a HR for CVD of 1.14 (95% CI, 1.04-1.25, p = 0.004). Conclusion: More CVD patients treated with atorvastatin than simvastatin achieved either LDL-C goal and those reaching the 2.0 mmol/l goal exhibited significantly less CVD than those only reaching 2.5 mmol/l. In those reaching the 2.0 mmol/l goal, the apoB/A1 ratio still bears a relation to CVD outcome. The use of apoB/A1 ratio may provide additional predictive value to that of LDL-C.

Place, publisher, year, edition, pages
Lippincott Williams and Wilkins , 2011. Vol. 18, no 2, 262-269 p.
Keyword [en]
Apolipoprotein, atorvastatin, coronary heart disease, lipoproteins, prevention, simvastatin
National Category
Medical and Health Sciences
URN: urn:nbn:se:liu:diva-68225DOI: 10.1177/1741826710389391ISI: 000289895800017OAI: diva2:416859
Available from: 2011-05-13 Created: 2011-05-13 Last updated: 2011-05-13

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Olsson, Anders
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Internal MedicineFaculty of Health SciencesDepartment of Endocrinology and Gastroenterology UHL
Medical and Health Sciences

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