Document Detail


Safety and efficacy of achieving very low low-density lipoprotein cholesterol levels with rosuvastatin 40 mg daily (from the ASTEROID Study).
MedLine Citation:
PMID:  19576317     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Clinical trial evidence supports the use of intensive statin therapy for patients with coronary artery disease. High doses of potent statins have shown the greatest clinical benefit, but concerns persist regarding the efficacy and safety of achieving very low levels of low-density lipoprotein (LDL) cholesterol. We grouped patients treated with 40 mg of rosuvastatin daily by the LDL cholesterol achieved according to previous work (<40, 40 to <60, 60 to <80, 80 to <100, and > or =100 mg/dl) and by National Cholesterol Education Program targets (<70, 70 to <100, and > or =100 mg/dl) in A Study to Evaluate the Effect of Rosuvastatin on Intravascular Ultrasound-Derived Coronary Atheroma Burden (ASTEROID). The rates of key safety end points, including death, hemorrhagic stroke, and liver and muscle enzyme elevations, and key efficacy end points (atheroma burden) were compared using chi-square testing or Fisher's exact testing. The analysis included 471 patients who had had their LDL cholesterol measured at 3 months, of whom 340 (72.2%) had LDL cholesterol of <70 mg/dl, exhibiting excellent achievement of even the most stringent guideline-based goals. Of these 471 subjects, 192 (40.8%) had LDL cholesterol > or =40 mg/dl but <60 mg/dl, and 57 (12.1%) had LDL cholesterol <40 mg/dl. Adverse events occurred infrequently during the trial, and no pattern appeared relating the frequency of any adverse event to the achieved LDL cholesterol. Similarly, the on-treatment atheroma volume, change in atheroma volume, and high percentage of subjects with atheroma regression did not differ by the achieved LDL cholesterol. In conclusion, although the power to detect such changes was limited, these data showed no clear relation between the LDL cholesterol achieved by intensive statin therapy with rosuvastatin and adverse effects. Atheroma regression occurred in most patients and was not linked to the LDL cholesterol achieved.
Authors:
Stephen D Wiviott; Satishkumar Mohanavelu; Joel S Raichlen; Valerie A Cain; Steven E Nissen; Peter Libby
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Research Support, Non-U.S. Gov't     Date:  2009-05-04
Journal Detail:
Title:  The American journal of cardiology     Volume:  104     ISSN:  1879-1913     ISO Abbreviation:  Am. J. Cardiol.     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-06     Completed Date:  2009-07-24     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0207277     Medline TA:  Am J Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  29-35     Citation Subset:  AIM; IM    
Affiliation:
Cardiovascular Division, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA. swiviott@partners.org
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MeSH Terms
Descriptor/Qualifier:
Aged
Cholesterol, VLDL / drug effects*
Coronary Artery Disease / drug therapy*,  physiopathology
Female
Fluorobenzenes / adverse effects,  therapeutic use*
Humans
Hydroxymethylglutaryl-CoA Reductase Inhibitors / adverse effects,  therapeutic use*
Hyperlipidemias / drug therapy*,  physiopathology
Male
Middle Aged
Prospective Studies
Pyrimidines / adverse effects,  therapeutic use*
Statistics, Nonparametric
Sulfonamides / adverse effects,  therapeutic use*
Chemical
Reg. No./Substance:
0/Cholesterol, VLDL; 0/Fluorobenzenes; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Pyrimidines; 0/Sulfonamides; 287714-41-4/rosuvastatin

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