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Low-density lipoprotein cholesterol reduction and goal achievement with ezetimibe/simvastatin versus atorvastatin or rosuvastatin in patients with diabetes, metabolic syndrome, or neither disease, stratified by National Cholesterol Education Program risk category.
Metab Syndr Relat Disord. 2009 Dec; 7(6):601-10.MS

Abstract

BACKGROUND

Patients with diabetes mellitus (DM) and metabolic syndrome are at increased risk of coronary heart disease (CHD). Studies have shown differential statin efficacy on low-density lipid cholesterol (LDL-C) by CHD risk strata.

OBJECTIVE

The aim of this study was to evaluate the consistency of effect with ezetimibe/simvastatin (E/S) combination therapy, atorvastatin, or rosuvastatin in patients with DM, metabolic syndrome, or neither condition (No DM/metabolic syndrome), stratified by the National Cholesterol Education Panel Adult Treatment Panel III (NCEP ATP III) CHD risk group.

METHODS

Post hoc analyses of 2 multicenter, double-blind, randomized, 6-week studies comparing E/S 10/10, 10/20, 10/40, or 10/80 mg with either atorvastatin 10, 20, 40, or 80 mg, or rosuvastatin 10, 20, or 40 mg. Treatments were compared by pooling across all doses for LDL-C reduction and NCEP LDL-C goal attainment in patients with DM, metabolic syndrome without DM, or No DM/metabolic syndrome across NCEP CHD risk strata.

RESULTS

NCEP LDL-C goal attainment was lowest in the high-risk group with atherosclerotic vascular disease (12-64%) and greatest in the moderate and low-risk groups (84-100%). In contrast, LDL-C reduction was generally similar irrespective of disease or risk subgroup. All treatments were generally well tolerated, with overall similar safety regardless of disease and risk level.

CONCLUSIONS

In these studies, CHD risk strata were inversely related to the likelihood of attaining NCEP LDL-C goals, but did not appear to affect the percentage LDL-C change from baseline. This demonstrates the need for especially aggressive cholesterol lowering necessary to reach the lower LDL-C goal for high-risk patients.

Links

Publisher Full Text

Authors+Show Affiliations

Polis AB
Merck & Co., Inc, West Point, Pennsylvania, USA.
Abate N
No affiliation info available
Catapano AL
No affiliation info available
Ballantyne CM
No affiliation info available
Davidson MH
No affiliation info available
Smugar SS
No affiliation info available
Tershakovec AM
No affiliation info available

MeSH

AgedAnticholesteremic AgentsAtorvastatinAzetidinesCholesterol, LDLCoronary DiseaseDiabetes MellitusDouble-Blind MethodDrug CombinationsEzetimibe, Simvastatin Drug CombinationFemaleFluorobenzenesHeptanoic AcidsHumansHydroxymethylglutaryl-CoA Reductase InhibitorsMaleMetabolic SyndromeMiddle AgedPyrimidinesPyrrolesRisk FactorsRosuvastatin CalciumSimvastatinSulfonamides

Pub Type(s)

Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

19929597

Citation

Polis, Adam B., et al. "Low-density Lipoprotein Cholesterol Reduction and Goal Achievement With Ezetimibe/simvastatin Versus Atorvastatin or Rosuvastatin in Patients With Diabetes, Metabolic Syndrome, or Neither Disease, Stratified By National Cholesterol Education Program Risk Category." Metabolic Syndrome and Related Disorders, vol. 7, no. 6, 2009, pp. 601-10.
Polis AB, Abate N, Catapano AL, et al. Low-density lipoprotein cholesterol reduction and goal achievement with ezetimibe/simvastatin versus atorvastatin or rosuvastatin in patients with diabetes, metabolic syndrome, or neither disease, stratified by National Cholesterol Education Program risk category. Metab Syndr Relat Disord. 2009;7(6):601-10.
Polis, A. B., Abate, N., Catapano, A. L., Ballantyne, C. M., Davidson, M. H., Smugar, S. S., & Tershakovec, A. M. (2009). Low-density lipoprotein cholesterol reduction and goal achievement with ezetimibe/simvastatin versus atorvastatin or rosuvastatin in patients with diabetes, metabolic syndrome, or neither disease, stratified by National Cholesterol Education Program risk category. Metabolic Syndrome and Related Disorders, 7(6), 601-10. https://doi.org/10.1089/met.2009.0009
Polis AB, et al. Low-density Lipoprotein Cholesterol Reduction and Goal Achievement With Ezetimibe/simvastatin Versus Atorvastatin or Rosuvastatin in Patients With Diabetes, Metabolic Syndrome, or Neither Disease, Stratified By National Cholesterol Education Program Risk Category. Metab Syndr Relat Disord. 2009;7(6):601-10. PubMed PMID: 19929597.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Low-density lipoprotein cholesterol reduction and goal achievement with ezetimibe/simvastatin versus atorvastatin or rosuvastatin in patients with diabetes, metabolic syndrome, or neither disease, stratified by National Cholesterol Education Program risk category. AU - Polis,Adam B, AU - Abate,Nicola, AU - Catapano,Alberico L, AU - Ballantyne,Christie M, AU - Davidson,Michael H, AU - Smugar,Steven S, AU - Tershakovec,Andrew M, PY - 2009/11/26/entrez PY - 2009/11/26/pubmed PY - 2010/3/5/medline SP - 601 EP - 10 JF - Metabolic syndrome and related disorders JO - Metab Syndr Relat Disord VL - 7 IS - 6 N2 - BACKGROUND: Patients with diabetes mellitus (DM) and metabolic syndrome are at increased risk of coronary heart disease (CHD). Studies have shown differential statin efficacy on low-density lipid cholesterol (LDL-C) by CHD risk strata. OBJECTIVE: The aim of this study was to evaluate the consistency of effect with ezetimibe/simvastatin (E/S) combination therapy, atorvastatin, or rosuvastatin in patients with DM, metabolic syndrome, or neither condition (No DM/metabolic syndrome), stratified by the National Cholesterol Education Panel Adult Treatment Panel III (NCEP ATP III) CHD risk group. METHODS: Post hoc analyses of 2 multicenter, double-blind, randomized, 6-week studies comparing E/S 10/10, 10/20, 10/40, or 10/80 mg with either atorvastatin 10, 20, 40, or 80 mg, or rosuvastatin 10, 20, or 40 mg. Treatments were compared by pooling across all doses for LDL-C reduction and NCEP LDL-C goal attainment in patients with DM, metabolic syndrome without DM, or No DM/metabolic syndrome across NCEP CHD risk strata. RESULTS: NCEP LDL-C goal attainment was lowest in the high-risk group with atherosclerotic vascular disease (12-64%) and greatest in the moderate and low-risk groups (84-100%). In contrast, LDL-C reduction was generally similar irrespective of disease or risk subgroup. All treatments were generally well tolerated, with overall similar safety regardless of disease and risk level. CONCLUSIONS: In these studies, CHD risk strata were inversely related to the likelihood of attaining NCEP LDL-C goals, but did not appear to affect the percentage LDL-C change from baseline. This demonstrates the need for especially aggressive cholesterol lowering necessary to reach the lower LDL-C goal for high-risk patients. SN - 1557-8518 UR - https://www.unboundmedicine.com/medline/citation/19929597/Low_density_lipoprotein_cholesterol_reduction_and_goal_achievement_with_ezetimibe/simvastatin_versus_atorvastatin_or_rosuvastatin_in_patients_with_diabetes_metabolic_syndrome_or_neither_disease_stratified_by_National_Cholesterol_Education_Program_risk_category_ L2 - https://www.liebertpub.com/doi/10.1089/met.2009.0009?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -
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