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Comparison of the efficacy and safety of atorvastatin initiated at different starting doses in patients with dyslipidemia.
Am Heart J. 2005 Jan; 149(1):e1.AH

Abstract

BACKGROUND

The NASDAC study was designed to evaluate the safety and efficacy of atorvastatin at starting doses of 10, 20, 40, and 80 mg.

METHODS

After an 8-week placebo washout period, 919 patients who were candidates for lipid-lowering therapy according to the National Cholesterol Education Program's Adult Treatment Panel III guidelines were randomized to 1 of 4 atorvastatin treatment groups: 10 mg (n = 229), 20 mg (n = 228), 40 mg (n = 231), and 80 mg (n = 231).

RESULTS

Atorvastatin reduced low-density lipoprotein cholesterol (LDL-C) levels dose dependently across the 10- to 80-mg-dose range (35.7%-52.2%). Each of the 20-, 40-, and 80-mg doses provided significantly greater decreases in LDL-C than all lower doses (P < .01). All doses also reduced total cholesterol, the LDL-C/high-density lipoprotein cholesterol ratio, apolipoprotein B, and triglycerides from baseline. An increase in high-density lipoprotein cholesterol was observed in all dose groups. Most participants, regardless of their level of coronary heart disease risk, attained their National Cholesterol Education Program's Adult Treatment Panel III LDL-C goal by the end of the study. Patients in all risk groups were more likely to achieve the NCEP LDL-C goal at higher starting doses. Atorvastatin was well tolerated at all dose levels.

CONCLUSIONS

Atorvastatin initiated at doses of 10, 20, 40, and 80 mg is effective and safe for the treatment of patients with dyslipidemia. Depending on the percentage reduction needed to achieve an LDL-C goal, patients with or at risk of coronary heart disease may benefit from starting therapy at a higher dose of atorvastatin.

Authors+Show Affiliations

Section of Atherosclerosis and Lipid Research, Baylor College of Medicine, Houston, Tex 77030, USA. jones@bcm.tmc.eduNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

15660024

Citation

Jones, Peter H., et al. "Comparison of the Efficacy and Safety of Atorvastatin Initiated at Different Starting Doses in Patients With Dyslipidemia." American Heart Journal, vol. 149, no. 1, 2005, pp. e1.
Jones PH, McKenney JM, Karalis DG, et al. Comparison of the efficacy and safety of atorvastatin initiated at different starting doses in patients with dyslipidemia. Am Heart J. 2005;149(1):e1.
Jones, P. H., McKenney, J. M., Karalis, D. G., & Downey, J. (2005). Comparison of the efficacy and safety of atorvastatin initiated at different starting doses in patients with dyslipidemia. American Heart Journal, 149(1), e1.
Jones PH, et al. Comparison of the Efficacy and Safety of Atorvastatin Initiated at Different Starting Doses in Patients With Dyslipidemia. Am Heart J. 2005;149(1):e1. PubMed PMID: 15660024.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of the efficacy and safety of atorvastatin initiated at different starting doses in patients with dyslipidemia. AU - Jones,Peter H, AU - McKenney,James M, AU - Karalis,Dean G, AU - Downey,Jackson, PY - 2005/1/22/pubmed PY - 2005/5/17/medline PY - 2005/1/22/entrez SP - e1 EP - e1 JF - American heart journal JO - Am Heart J VL - 149 IS - 1 N2 - BACKGROUND: The NASDAC study was designed to evaluate the safety and efficacy of atorvastatin at starting doses of 10, 20, 40, and 80 mg. METHODS: After an 8-week placebo washout period, 919 patients who were candidates for lipid-lowering therapy according to the National Cholesterol Education Program's Adult Treatment Panel III guidelines were randomized to 1 of 4 atorvastatin treatment groups: 10 mg (n = 229), 20 mg (n = 228), 40 mg (n = 231), and 80 mg (n = 231). RESULTS: Atorvastatin reduced low-density lipoprotein cholesterol (LDL-C) levels dose dependently across the 10- to 80-mg-dose range (35.7%-52.2%). Each of the 20-, 40-, and 80-mg doses provided significantly greater decreases in LDL-C than all lower doses (P < .01). All doses also reduced total cholesterol, the LDL-C/high-density lipoprotein cholesterol ratio, apolipoprotein B, and triglycerides from baseline. An increase in high-density lipoprotein cholesterol was observed in all dose groups. Most participants, regardless of their level of coronary heart disease risk, attained their National Cholesterol Education Program's Adult Treatment Panel III LDL-C goal by the end of the study. Patients in all risk groups were more likely to achieve the NCEP LDL-C goal at higher starting doses. Atorvastatin was well tolerated at all dose levels. CONCLUSIONS: Atorvastatin initiated at doses of 10, 20, 40, and 80 mg is effective and safe for the treatment of patients with dyslipidemia. Depending on the percentage reduction needed to achieve an LDL-C goal, patients with or at risk of coronary heart disease may benefit from starting therapy at a higher dose of atorvastatin. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/15660024/Comparison_of_the_efficacy_and_safety_of_atorvastatin_initiated_at_different_starting_doses_in_patients_with_dyslipidemia_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0002870304004764 DB - PRIME DP - Unbound Medicine ER -