Attaining United Kingdom-European Atherosclerosis Society low-density lipoprotein cholesterol guideline target values in the Greek Atorvastatin and Coronary-heart-disease Evaluation (GREACE) Study.
The GREek Atorvastatin and Coronary-heart-disease Evaluation (GREACE) Study compared two standards (structured vs. usual care) of lipid lowering treatment in 1600 patients with coronary heart disease (CHD). Structured care aimed at achieving (with atorvastatin 10-80 mg) the low-density lipoprotein cholesterol (LDL-C) (2.6 mmol/l; 100 mg/dl) goal described in the NCEP ATP II and III guidelines for patients with CHD. Structured care was associated with a significant reduction in overall mortality and coronary events compared to usual care. In the present brief report we interpret the results of GREACE using the United Kingdom (UK) and European Atherosclerosis Society (EAS) treatment goal for LDL-C in secondary CHD prevention (3.0 mmol/l; 115 mg/dl. The mean dose of atorvastatin decreased from 24 mg to 22 mg/day. More patients achieved the UK and EAS LDL-C target (95.6 vs. 95%) in the structured care arm of the trial; 90% of the patients achieved this target with 10 or 20 mg atorvastatin. These findings may have cost implications, especially if the LDL-C target for high-risk patients will fall below those described above.
Athyros
Vasilios G
VG
Atherosclerosis Unit, Aristotelian University, Hippocration Hospital, 49 Konstantinoupoleos St, Thessaloniki, 546 42, Greece. athyros@med.auth.gr
Mikhailidis
Dimitri P
DP
Papageorgiou
Athanasios A
AA
Mercouris
Bodosakis R
BR
Athyrou
Valasia V
VV
Symeonidis
Athanasios N
AN
Basayannis
Elias O
EO
Demitriadis
Dimokritos S
DS
Kontopoulos
Athanasios G
AG
D000924:Anticholesteremic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D000069059:Atorvastatin; D008078:Cholesterol, LDL / Q000097:blood* / Q000592:standards; D003327:Coronary Disease / Q000097:blood / Q000188:drug therapy / Q000517:prevention & control*; D005060:Europe; D019983:Guideline Adherence; D006538:Heptanoic Acids / Q000008:administration & dosage / Q000627:therapeutic use*; D006801:Humans; D009203:Myocardial Infarction; D017410:Practice Guidelines as Topic; D011314:Preventive Health Services / Q000592:standards*; D011758:Pyrroles / Q000008:administration & dosage / Q000627:therapeutic use*; D012952:Societies; D020521:Stroke; D006113:United Kingdom
D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D011758:Pyrroles; D000069059:Atorvastatin