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Achieving LDL cholesterol, non-HDL cholesterol, and apolipoprotein B target levels in high-risk patients: Measuring Effective Reductions in Cholesterol Using Rosuvastatin therapY (MERCURY) II.
Am Heart J. 2006 May; 151(5):975.e1-9.AH

Abstract

BACKGROUND

National Cholesterol Education Program Adult Treatment Panel III guidelines for patients at a high risk of coronary heart disease set a low-density lipoprotein cholesterol (LDL-C) target of < 100 mg/dL. This target can be difficult to attain with diet and current therapy.

METHODS

In a 16-week multinational trial, 1993 high-risk patients were randomized to rosuvastatin 20 mg, atorvastatin 10 mg, atorvastatin 20 mg, simvastatin 20 mg, or simvastatin 40 mg for 8 weeks. Patients either remained on starting treatment or switched to lower or milligram-equivalent doses of rosuvastatin for 8 more weeks.

RESULTS

At 16 weeks, more patients achieved their LDL-C target by switching to rosuvastatin 10 mg than staying on atorvastatin 10 mg (66% vs 42%, P < .001) or simvastatin 20 mg (73% vs 32%, P < .001). Changing to rosuvastatin 20 mg brought more patients to their LDL-C target than staying on atorvastatin 20 mg (79% vs 64%, P < .001) or simvastatin 40 mg (84% vs 56%, P < .001). More very high risk patients achieved an LDL-C target of < 70 mg/dL when changed to rosuvastatin from atorvastatin or simvastatin (within-arm comparisons P < .01). More hypertriglyceridemic patients (triglycerides > or = 200 mg/dL) met LDL-C, non-high-density lipoprotein cholesterol (non-HDL-C), and apolipoprotein B targets by changing to rosuvastatin. Switching to rosuvastatin produced greater reductions in LDL-C, total cholesterol, non-HDL-C, apolipoprotein B, and lipid ratios. All treatments were well tolerated, with no differences among treatment groups in skeletal muscle, hepatic, or renal toxicity.

CONCLUSION

Rosuvastatin 10 or 20 mg is an effective and safe therapeutic option for high-risk patients to achieve their lipid and apolipoprotein targets.

Authors+Show Affiliations

Ballantyne CM
Methodist DeBakey Heart Center, Baylor College of Medicine, Houston, TX, USA. cmb@bcm.tmc.edu
Bertolami M
No affiliation info available
Hernandez Garcia HR
No affiliation info available
Nul D
No affiliation info available
Stein EA
No affiliation info available
Theroux P
No affiliation info available
Weiss R
No affiliation info available
Cain VA
No affiliation info available
Raichlen JS
No affiliation info available

MeSH

AgedApolipoproteins BAtorvastatinCholesterolCholesterol, LDLCoronary DiseaseDose-Response Relationship, DrugFemaleFluorobenzenesHeptanoic AcidsHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMiddle AgedPyrimidinesPyrrolesRisk FactorsRosuvastatin CalciumSimvastatinSulfonamidesTreatment Outcome

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

16644314

Citation

Ballantyne, Christie M., et al. "Achieving LDL Cholesterol, non-HDL Cholesterol, and Apolipoprotein B Target Levels in High-risk Patients: Measuring Effective Reductions in Cholesterol Using Rosuvastatin therapY (MERCURY) II." American Heart Journal, vol. 151, no. 5, 2006, pp. 975.e1-9.
Ballantyne CM, Bertolami M, Hernandez Garcia HR, et al. Achieving LDL cholesterol, non-HDL cholesterol, and apolipoprotein B target levels in high-risk patients: Measuring Effective Reductions in Cholesterol Using Rosuvastatin therapY (MERCURY) II. Am Heart J. 2006;151(5):975.e1-9.
Ballantyne, C. M., Bertolami, M., Hernandez Garcia, H. R., Nul, D., Stein, E. A., Theroux, P., Weiss, R., Cain, V. A., & Raichlen, J. S. (2006). Achieving LDL cholesterol, non-HDL cholesterol, and apolipoprotein B target levels in high-risk patients: Measuring Effective Reductions in Cholesterol Using Rosuvastatin therapY (MERCURY) II. American Heart Journal, 151(5), e1-9.
Ballantyne CM, et al. Achieving LDL Cholesterol, non-HDL Cholesterol, and Apolipoprotein B Target Levels in High-risk Patients: Measuring Effective Reductions in Cholesterol Using Rosuvastatin therapY (MERCURY) II. Am Heart J. 2006;151(5):975.e1-9. PubMed PMID: 16644314.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Achieving LDL cholesterol, non-HDL cholesterol, and apolipoprotein B target levels in high-risk patients: Measuring Effective Reductions in Cholesterol Using Rosuvastatin therapY (MERCURY) II. AU - Ballantyne,Christie M, AU - Bertolami,Marcelo, AU - Hernandez Garcia,Hugo Ricardo, AU - Nul,Daniel, AU - Stein,Evan A, AU - Theroux,Pierre, AU - Weiss,Robert, AU - Cain,Valerie A, AU - Raichlen,Joel S, PY - 2005/09/12/received PY - 2005/12/14/accepted PY - 2006/4/29/pubmed PY - 2006/5/27/medline PY - 2006/4/29/entrez SP - 975.e1 EP - 9 JF - American heart journal JO - Am Heart J VL - 151 IS - 5 N2 - BACKGROUND: National Cholesterol Education Program Adult Treatment Panel III guidelines for patients at a high risk of coronary heart disease set a low-density lipoprotein cholesterol (LDL-C) target of < 100 mg/dL. This target can be difficult to attain with diet and current therapy. METHODS: In a 16-week multinational trial, 1993 high-risk patients were randomized to rosuvastatin 20 mg, atorvastatin 10 mg, atorvastatin 20 mg, simvastatin 20 mg, or simvastatin 40 mg for 8 weeks. Patients either remained on starting treatment or switched to lower or milligram-equivalent doses of rosuvastatin for 8 more weeks. RESULTS: At 16 weeks, more patients achieved their LDL-C target by switching to rosuvastatin 10 mg than staying on atorvastatin 10 mg (66% vs 42%, P < .001) or simvastatin 20 mg (73% vs 32%, P < .001). Changing to rosuvastatin 20 mg brought more patients to their LDL-C target than staying on atorvastatin 20 mg (79% vs 64%, P < .001) or simvastatin 40 mg (84% vs 56%, P < .001). More very high risk patients achieved an LDL-C target of < 70 mg/dL when changed to rosuvastatin from atorvastatin or simvastatin (within-arm comparisons P < .01). More hypertriglyceridemic patients (triglycerides > or = 200 mg/dL) met LDL-C, non-high-density lipoprotein cholesterol (non-HDL-C), and apolipoprotein B targets by changing to rosuvastatin. Switching to rosuvastatin produced greater reductions in LDL-C, total cholesterol, non-HDL-C, apolipoprotein B, and lipid ratios. All treatments were well tolerated, with no differences among treatment groups in skeletal muscle, hepatic, or renal toxicity. CONCLUSION: Rosuvastatin 10 or 20 mg is an effective and safe therapeutic option for high-risk patients to achieve their lipid and apolipoprotein targets. SN - 1097-6744 UR - https://www.unboundmedicine.com/medline/citation/16644314/Achieving_LDL_cholesterol_non_HDL_cholesterol_and_apolipoprotein_B_target_levels_in_high_risk_patients:_Measuring_Effective_Reductions_in_Cholesterol_Using_Rosuvastatin_therapY__MERCURY__II_ DB - PRIME DP - Unbound Medicine ER -
Grapherence [↓23]

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