title: Efficacy of atorvastatin after LDL-cholesterol-based dose selection in high risk dyslipidaemic patients: results of the target dose study.
abstract: BACKGROUND
  Hypercholesterolaemia is one of the major risk factors for the development of coronary heart disease (CHD). European guidelines emphasize the importance of reducing low-density lipoprotein cholesterol (LDL-C) levels below 115 mg/dL (3.0 mmol/L) in patients with high CHD risk.
  
  
  OBJECTIVE
  The present study evaluates whether selection of the atorvastatin starting dose based on baseline LDL-C levels and previous statin treatment status would result in an achievement of LDL-C targets without the need for up-titration.
  
  
  METHODS
  A multicentre, prospective, open-label study conducted in Belgium. Patients were at high risk defined as either a history of CHD, another atherosclerotic disease, diabetes mellitus Type 2 or an estimated 10-year CHD risk > 20%. The primary endpoint was the proportion of patients achieving the LDL-C goal after 12 weeks of treatment.
  
  
  RESULTS
  Overall, 96.4% of the 195 statin-naïve patients reached the LDL-C target after 12 weeks of treatment. The majority of the patients (95.4%) already reached LDL-C control at Week 6. Mean (SD) LDL-C levels decreased from 159 (25) mg/dL[(4.1 (0.6) mmol/L] to 86 (14) mg/dL [2.2 (0.4) mmol/L] after 12 weeks of treatment. Only 4.6% of the patients needed an up-titration at Week 6.
  
  
  CONCLUSIONS
  Taken together, the results demonstrate that LDL-C based dose selection of atorvastatin is highly efficacious for rapid achievement of target LDL-C levels with a low need for up-titration. Application of this flexible first dosing strategy in general practice will, based on available evidence, increase adherence to atorvastatin treatment in patients with high CHD risk.
authors.affiliation: C.H.U. Tivoli, La Louvière, Belgium. jean.ducobu@chu-tivoli.be <ducobu@chu-tivoli.be>
authors.forename: Jean
authors.initials: J
authors.lastname: Ducobu
authors.forename: Marc
authors.initials: M
authors.lastname: Claeys
authors.forename: Kathleen
authors.initials: K
authors.lastname: Commers
authors.forename: W
authors.initials: W
authors.lastname: Van Mieghem
authors.forename: H
authors.initials: H
authors.lastname: Nachtergaele
authors.forename: M
authors.initials: M
authors.lastname: Vandenbroucke
authors.forename: J
authors.initials: J
authors.lastname: Deforce
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000069059:Atorvastatin; D002097:C-Reactive Protein / Q000032:analysis; D008078:Cholesterol, LDL / Q000097:blood; D003327:Coronary Disease / Q000150:complications; D004305:Dose-Response Relationship, Drug; D050171:Dyslipidemias / Q000150:complications / Q000188:drug therapy*; D005260:Female; D006538:Heptanoic Acids / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011758:Pyrroles / Q000008:administration & dosage / Q000009:adverse effects / Q000627:therapeutic use*; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D008078:Cholesterol, LDL; D006538:Heptanoic Acids; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D011758:Pyrroles; D002097:C-Reactive Protein; D000069059:Atorvastatin