Efficacy of atorvastatin for achieving cholesterol targets after LDL-cholesterol based dose selection in patients with type 2 diabetes.

We analyzed the feasibility of an intensive lipid-lowering strategy based on a starting dose of atorvastatin according to baseline and target low-density lipoprotein cholesterol (LDL-C) level (<2.6 mmol/L) in 202 statin-naïve patients with type 2 diabetes within 24 weeks. They were assigned to receive a daily dosage of atorvastatin based on their initial LDL-C levels. The primary endpoint was the proportion of patients achieving the LDL-C goal after 24 weeks of treatment. No changes were made in prescribed atorvastatin dosage. At the study end, 66.5% of the 188 patients completing the trial reached the LDL-C target (75%, 67%, 58% and 59% with 10, 20, 40 and 80 mg per day of atorvastatin, respectively) reached LDL-C target. Atorvastatin reduced the levels of total cholesterol, LDL-C, high density lipoprotein cholesterol (HDL-C) and triglycerides by 29%, 35%, 3% and 22%, respectively, and all statin doses were well tolerated. Thus, individualizing the starting dose of atorvastatin according to baseline and target LDL-C levels, allowed a high proportion of type 2 diabetic patients to achieve the target within 24 weeks.