Asan Medical Center, Seoul, South Korea.
Cardiovasc Drugs Ther. 2010 Apr;24(2):181-8. doi: 10.1007/s10557-010-6225-0.
This study was designed to evaluate the safety and efficacy of algorithm-based atorvastatin therapy initiated at different starting doses of 10, 20, and 40 mg in Korean dyslipidemic patients.
Five hundred seventy-four patients were screened, and 425 were enrolled (low risk, n = 29; intermediate risk, n = 45; high risk, n = 351). The starting dose depended on a patient's cardiovascular risk and LDL-cholesterol (LDL-C) levels.
Of the patients, 253 (59.5%), 63 (14.8%) and 109 (25.6%) patients were assigned at baseline to 10 mg, 20 mg and 40 mg atorvastatin, respectively. 390 patients (91.8%) completed the study, and 35 discontinued prematurely. No patient in the low or intermediate risk groups was titrated to 80 mg at Week 4, whereas, 26 in the high risk group were. 81.9% of patients achieved their LDL-C target at Week 4, which was sustained through to Week 8 (86.0%). 89.1% of patients who were not titrated achieved their LDL-C target at Week 8, and 82.1% of patients who were titrated 1 step up achieved their LDL-C target at Week 8. Overall, about 40% reduction in LDL-C, non-HDL-C levels, and LDL-C/HDL-C ratio was observed during the follow-up. Triglyceride was reduced by approximately 10% by Week 8. HDL cholesterol was slightly increased over 8 weeks (2.6%). Atorvastatin was well tolerated at all dose levels.
Patient-tailored statin therapy according to an individual's risk category and LDL-C levels was safe and effective with a quick achievement of LDL-C target in Korean dyslipidemic patients.
本研究旨在评估在韩国血脂异常患者中,起始剂量分别为 10、20 和 40mg 的基于算法的阿托伐他汀治疗的安全性和有效性。
筛选了 574 名患者,其中 425 名符合条件(低危组 n=29,中危组 n=45,高危组 n=351)。起始剂量取决于患者的心血管风险和 LDL-胆固醇(LDL-C)水平。
基线时,253 名(59.5%)、63 名(14.8%)和 109 名(25.6%)患者分别被分配到阿托伐他汀 10mg、20mg 和 40mg 组。390 名(91.8%)患者完成了研究,35 名患者提前退出。低危或中危组无患者在第 4 周时滴定至 80mg,而高危组有 26 名。第 4 周时 81.9%的患者达到 LDL-C 目标,该目标一直持续到第 8 周(86.0%)。未滴定的 89.1%患者在第 8 周达到 LDL-C 目标,滴定 1 步的 82.1%患者在第 8 周达到 LDL-C 目标。总的来说,在随访期间,LDL-C、非 HDL-C 水平和 LDL-C/HDL-C 比值降低了约 40%。第 8 周时,甘油三酯降低了约 10%。HDL 胆固醇在 8 周内略有增加(2.6%)。所有剂量水平的阿托伐他汀均耐受良好。
根据患者的风险类别和 LDL-C 水平,为患者量身定制的他汀类药物治疗在韩国血脂异常患者中是安全有效的,能够快速达到 LDL-C 目标。