Use of Moderate-Intensity Statins for Low-Density Lipoprotein Cholesterol Level above 190 mg/dL at Baseline in Koreans.
The ACC/AHA 2013 guideline recommends high-intensity statin therapy for a decrease in low-density lipoprotein cholesterol (LDL-C) level by >50% among patients with baseline values of ≥190 mg/dL (approximately 4.872 mmol/L); however, this value should be modified before applying it to Korean populations. We investigated the statin-specific LDL-C-lowering effects in Korean patients with baseline LDL-C value ≥4.872 mmol/L. Data of patients prescribed a statin for the first time from January 2009 to December 2013 were assessed. In patients with baseline LDL-C value ≥4.872 mmol/L, laboratory data for a maximum of 6 months from the date of first statin prescription were collected. Among 33,721 patients who were prescribed a statin for the first time, 655 patients had a baseline LDL-C value ≥4.872 mmol/L (1.9%). Of these, 179 patients were analysed. Patients receiving moderate-intensity statins were divided into two groups based on LDL-C reduction rate (p = 0.0002), defined as moderate-high-intensity (atorvastatin 20 mg, rosuvastatin 10 mg, simvastatin 20 mg) and moderate-low-intensity (atorvastatin 10 mg, pitavastatin 2 mg, pravastatin 40 mg) statin groups. LDL-C reduction rates did not significantly differ between the moderate-high- and high-intensity statin groups (p = 0.4895). We found that some moderate-intensity statins demonstrated a LDL-C-lowering effect of more than 50% in Korean patients with a baseline LDL-C value ≥4.872 mmol/L. Our results reflect the need of a large-scale, randomized, controlled trial on partial reclassification of statins for patients with baseline LDL-C value ≥4.872 mmol/L before adopting ACC/AHC guidelines in Korea.
Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea.|Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
Hun-Sung
HS
Kim
Department of Industrial and Management Engineering, Pohang University of Science and Technology, Seoul, Korea.
Hyeseon
H
Lee
Division of Biomedical Informatics, Systems Biomedical Informatics Research Centre, Seoul National University College of Medicine, Seoul, Korea.
Sue Hyun
SH
Lee
Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Yoo Jin
YJ
Jeong
Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Tong Min
TM
Kim
Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
So Jung
SJ
Yang
Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Sun Jung
SJ
Baik
College of Pharmacy, Sookmyung Women's University, Seoul, Korea.
Hyunah
H
Kim
Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
Seung-Hwan
SH
Lee
Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
Jae Hyoung
JH
Cho
Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea.
In-Young
IY
Choi
Department of Medical Informatics, College of Medicine, The Catholic University of Korea, Seoul, Korea.|Division of Endocrinology and Metabolism, Department of Internal Medicine, College of Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea, Seoul, Korea.
Kun-Ho
KH
Yoon
Division of Biomedical Informatics, Systems Biomedical Informatics Research Centre, Seoul National University College of Medicine, Seoul, Korea.
Ju Han
JH
Kim
D000368:Aged; D015415:Biomarkers / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood*; D015536:Down-Regulation; D011307:Drug Prescriptions; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D056910:Republic of Korea; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors