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Rising to the challenge of treating high-risk patients.
Am J Manag Care 2006; 12(11 Suppl):S318-24AJ

Abstract

Guidelines from the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) focus the need for the most intensive efforts to lower low-density lipoprotein cholesterol (LDL-C) in the patients at greatest risk of a major future clinical coronary heart disease event. Major clinical trials, such as Pravastatin or Atorvastatin Evaluation and Infection Therapy and the Heart Protection Study, demonstrated the value of lowering LDL-C levels in high-risk patients to well below the ATP III target of <100 mg/dL. In 2004, the NCEP writing group suggested that a more aggressive LDL-C goal of <70 mg/dL is an option when treating high-risk patients, particularly those with the presence of established cardiovascular disease plus major multiple risk factors (especially diabetes), severe and poorly controlled risk factors (ie, cigarette smoking), multiple criteria of the metabolic syndrome, or an acute coronary syndrome. With stricter targets, high-risk patients are less likely to achieve their cholesterol goals than lower risk patients. Recent large trials comparing rosuvastatin with other statin monotherapies have shown a greater LDL-C reduction and better attainment of goals with rosuvastatin. In addition, the MERCURY [Measuring Effective Reductions in Cholesterol Using Rosuvastatin Therapy] trials demonstrate that switching to rosuvastatin significantly increased the percentage of patients who achieved their ATP III LDL-C targets.

Authors+Show Affiliations

College of Medicine and Public Health, Ohio State University, 146 Means, 1654 Upham Dr, Columbus, OH 43210, USA. Guthrie.1@osu.edu

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17042674

Citation

Guthrie, Robert M.. "Rising to the Challenge of Treating High-risk Patients." The American Journal of Managed Care, vol. 12, no. 11 Suppl, 2006, pp. S318-24.
Guthrie RM. Rising to the challenge of treating high-risk patients. Am J Manag Care. 2006;12(11 Suppl):S318-24.
Guthrie, R. M. (2006). Rising to the challenge of treating high-risk patients. The American Journal of Managed Care, 12(11 Suppl), pp. S318-24.
Guthrie RM. Rising to the Challenge of Treating High-risk Patients. Am J Manag Care. 2006;12(11 Suppl):S318-24. PubMed PMID: 17042674.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Rising to the challenge of treating high-risk patients. A1 - Guthrie,Robert M, PY - 2006/10/18/pubmed PY - 2007/5/19/medline PY - 2006/10/18/entrez SP - S318 EP - 24 JF - The American journal of managed care JO - Am J Manag Care VL - 12 IS - 11 Suppl N2 - Guidelines from the National Cholesterol Education Program (NCEP) Adult Treatment Panel III (ATP III) focus the need for the most intensive efforts to lower low-density lipoprotein cholesterol (LDL-C) in the patients at greatest risk of a major future clinical coronary heart disease event. Major clinical trials, such as Pravastatin or Atorvastatin Evaluation and Infection Therapy and the Heart Protection Study, demonstrated the value of lowering LDL-C levels in high-risk patients to well below the ATP III target of <100 mg/dL. In 2004, the NCEP writing group suggested that a more aggressive LDL-C goal of <70 mg/dL is an option when treating high-risk patients, particularly those with the presence of established cardiovascular disease plus major multiple risk factors (especially diabetes), severe and poorly controlled risk factors (ie, cigarette smoking), multiple criteria of the metabolic syndrome, or an acute coronary syndrome. With stricter targets, high-risk patients are less likely to achieve their cholesterol goals than lower risk patients. Recent large trials comparing rosuvastatin with other statin monotherapies have shown a greater LDL-C reduction and better attainment of goals with rosuvastatin. In addition, the MERCURY [Measuring Effective Reductions in Cholesterol Using Rosuvastatin Therapy] trials demonstrate that switching to rosuvastatin significantly increased the percentage of patients who achieved their ATP III LDL-C targets. SN - 1088-0224 UR - https://www.unboundmedicine.com/medline/citation/17042674/Rising_to_the_challenge_of_treating_high_risk_patients_ L2 - https://www.ajmc.com/pubMed.php?pii=3211 DB - PRIME DP - Unbound Medicine ER -