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Percentage low-density lipoprotein-cholesterol response to a given statin dose is not fixed across the pre-treatment range : real world evidence from clinical practice : data from the ESC-EORP EUROASPIRE V study

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Abstract
Aims: Recent European guidelines recommend in patients with atherosclerotic cardiovascular disease to achieve a reduction of low-density lipoprotein-cholesterol of at least 50% if the baseline low-density lipoprotein-cholesterol level is between 1.8 and 3.5 mmol/L. Systematic reviews have associated a given statin/dose combination with a fixed percentage low-density lipoprotein-cholesterol response. Algorithms for detecting cases and estimating the prevalence of familial hypercholesterolaemia often rely on such fixed percentage reductions. Methods and results: We used data from 915 coronary patients participating in the EUROASPIRE V study in whom atorvastatin or rosuvastatin therapy was initiated at hospital discharge and who were still using these drugs at the same dose at a follow-up visit 6 or more months later. Pre and on-treatment low-density lipoprotein-cholesterol levels were compared across the full low-density lipoprotein-cholesterol range. The prevalence of FH was estimated using the Dutch Lipid Clinic Network criteria, once using observed pre-treatment low-density lipoprotein-cholesterol and once using imputed pre-treatment low-density lipoprotein-cholesterol by following the common strategy of applying fixed correction factors to on-treatment low-density lipoprotein-cholesterol. Inter-individual variation in the low-density lipoprotein-cholesterol response to a fixed statin and dose was considerable, with a strong inverse relation of percentage reductions to pre-treatment low-density lipoprotein-cholesterol. The percentage low-density lipoprotein-cholesterol response was markedly lower at the left end of the pre-treatment low-density lipoprotein-cholesterol range especially for levels less than 3 mmol/L. The estimated prevalence of familial hypercholesterolaemia was 2% if using observed pre-treatment low-density lipoprotein-cholesterol and 10% when using imputed low-density lipoprotein-cholesterol. Conclusion The inter-individual variation in the percentage low-density lipoprotein-cholesterol response to a given dose of a statin is largely dependent on the pre-treatment level: the lower the pre-treatment low-density lipoprotein-cholesterol level the smaller the percentage low-density lipoprotein-cholesterol reduction. The use of uniform correction factors to estimate pre-treatment low-density lipoprotein-cholesterol is not justified.
Keywords
Atherosclerotic cardiovascular disease, low-density lipoprotein-cholesterol, treatment target, familial hypercholesterolaemia, FAMILIAL HYPERCHOLESTEROLEMIA, PREVENTION GUIDELINES, HEART-DISEASE, RISK, REDUCTION, ROSUVASTATIN, METAANALYSIS, MANAGEMENT, IMPUTATION, THERAPY

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MLA
De Bacquer, Dirk, et al. “Percentage Low-Density Lipoprotein-Cholesterol Response to a given Statin Dose Is Not Fixed across the Pre-Treatment Range : Real World Evidence from Clinical Practice : Data from the ESC-EORP EUROASPIRE V Study.” EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY, 2020.
APA
De Bacquer, D., De Smedt, D., Reiner, Ž., Tokgözoğlu, L., Clays, E., Kotseva, K., … De Backer, G. (2020). Percentage low-density lipoprotein-cholesterol response to a given statin dose is not fixed across the pre-treatment range : real world evidence from clinical practice : data from the ESC-EORP EUROASPIRE V study. EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY.
Chicago author-date
De Bacquer, Dirk, Delphine De Smedt, Željko Reiner, Lale Tokgözoğlu, Els Clays, Kornelia Kotseva, Lars Rydén, David Wood, and Gui De Backer. 2020. “Percentage Low-Density Lipoprotein-Cholesterol Response to a given Statin Dose Is Not Fixed across the Pre-Treatment Range : Real World Evidence from Clinical Practice : Data from the ESC-EORP EUROASPIRE V Study.” EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY.
Chicago author-date (all authors)
De Bacquer, Dirk, Delphine De Smedt, Željko Reiner, Lale Tokgözoğlu, Els Clays, Kornelia Kotseva, Lars Rydén, David Wood, and Gui De Backer. 2020. “Percentage Low-Density Lipoprotein-Cholesterol Response to a given Statin Dose Is Not Fixed across the Pre-Treatment Range : Real World Evidence from Clinical Practice : Data from the ESC-EORP EUROASPIRE V Study.” EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY.
Vancouver
1.
De Bacquer D, De Smedt D, Reiner Ž, Tokgözoğlu L, Clays E, Kotseva K, et al. Percentage low-density lipoprotein-cholesterol response to a given statin dose is not fixed across the pre-treatment range : real world evidence from clinical practice : data from the ESC-EORP EUROASPIRE V study. EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY. 2020;
IEEE
[1]
D. De Bacquer et al., “Percentage low-density lipoprotein-cholesterol response to a given statin dose is not fixed across the pre-treatment range : real world evidence from clinical practice : data from the ESC-EORP EUROASPIRE V study,” EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY, 2020.
@article{8628982,
  abstract     = {Aims: Recent European guidelines recommend in patients with atherosclerotic cardiovascular disease to achieve a reduction of low-density lipoprotein-cholesterol of at least 50% if the baseline low-density lipoprotein-cholesterol level is between 1.8 and 3.5 mmol/L. Systematic reviews have associated a given statin/dose combination with a fixed percentage low-density lipoprotein-cholesterol response. Algorithms for detecting cases and estimating the prevalence of familial hypercholesterolaemia often rely on such fixed percentage reductions. Methods and results: We used data from 915 coronary patients participating in the EUROASPIRE V study in whom atorvastatin or rosuvastatin therapy was initiated at hospital discharge and who were still using these drugs at the same dose at a follow-up visit 6 or more months later. Pre and on-treatment low-density lipoprotein-cholesterol levels were compared across the full low-density lipoprotein-cholesterol range. The prevalence of FH was estimated using the Dutch Lipid Clinic Network criteria, once using observed pre-treatment low-density lipoprotein-cholesterol and once using imputed pre-treatment low-density lipoprotein-cholesterol by following the common strategy of applying fixed correction factors to on-treatment low-density lipoprotein-cholesterol. Inter-individual variation in the low-density lipoprotein-cholesterol response to a fixed statin and dose was considerable, with a strong inverse relation of percentage reductions to pre-treatment low-density lipoprotein-cholesterol. The percentage low-density lipoprotein-cholesterol response was markedly lower at the left end of the pre-treatment low-density lipoprotein-cholesterol range especially for levels less than 3 mmol/L. The estimated prevalence of familial hypercholesterolaemia was 2% if using observed pre-treatment low-density lipoprotein-cholesterol and 10% when using imputed low-density lipoprotein-cholesterol. Conclusion The inter-individual variation in the percentage low-density lipoprotein-cholesterol response to a given dose of a statin is largely dependent on the pre-treatment level: the lower the pre-treatment low-density lipoprotein-cholesterol level the smaller the percentage low-density lipoprotein-cholesterol reduction. The use of uniform correction factors to estimate pre-treatment low-density lipoprotein-cholesterol is not justified.},
  author       = {De Bacquer, Dirk and De Smedt, Delphine and Reiner, Željko and Tokgözoğlu, Lale and Clays, Els and Kotseva, Kornelia and Rydén, Lars and Wood, David and De Backer, Gui},
  issn         = {2047-4873},
  journal      = {EUROPEAN JOURNAL OF PREVENTIVE CARDIOLOGY},
  keywords     = {Atherosclerotic cardiovascular disease,low-density lipoprotein-cholesterol,treatment target,familial hypercholesterolaemia,FAMILIAL HYPERCHOLESTEROLEMIA,PREVENTION GUIDELINES,HEART-DISEASE,RISK,REDUCTION,ROSUVASTATIN,METAANALYSIS,MANAGEMENT,IMPUTATION,THERAPY},
  language     = {eng},
  title        = {Percentage low-density lipoprotein-cholesterol response to a given statin dose is not fixed across the pre-treatment range : real world evidence from clinical practice : data from the ESC-EORP EUROASPIRE V study},
  url          = {http://dx.doi.org/10.1177/2047487319874898},
  year         = {2020},
}

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