Abstrait

Effectiveness of using rosuvastatin in difficult-to-control dyslipidemia patients: An audit in secondary care

Jeetesh V Patel and Elizabeth A Hughes

Background: A substantial proportion of patients at risk of developing or with established cardiovascular disease still fail to meet British lipid targets (low-density lipoprotein cholesterol <3 mmol/l). The redress of this failure requires improved lipid-lowering treatment strategies. Methods: We audited the efficacy and safety (reported liver function, glycemic index, muscle effects, headache and hypersensitivity) of rosuvastatin therapy and other lipid-lowering treatments in 216 patients, (53.7% men, mean age: 60 years) attending a lipid clinic at Sandwell General Hospital (West Midlands, UK). Patient data were obtained from notes reviewed during lipid clinic referral, lipid clinic lipidlowering treatment before rosuvastatin and after 6 months’ management with rosuvastatin. Results: Familial hypercholesterolemia (38.4% [95% confidence interval: 31.9–44.9%]) and combined dyslipidemia (38.4% [31.9–44.9%]) were the most common forms of hyperlipidemia. At referral, 9.1% (3.4–14.8) were achieving the low-density lipoprotein cholesterol target. Following lipid-lowering treatment at the lipid clinic (mean time: 4.1 years), 24.2% (15.8–32.7%) of patients were at target before a change to rosuvastatin and 66.7% (57.4–76.0) were at target with rosuvastatin therapy (0.5 years treatment). Overall, the mean reduction in serum cholesterol after referral with lipidlowering treatment other than rosuvastatin was 1.6 [1.2–2.0] mmol/l (p < 0.05). An additional 0.7 (0.4–0.9) mmol/l reduction (p < 0.05) was observed with rosuvastatin. Adverse reactions to statin were no more common with rosuvastatin (2.0%) than other statins in its class (7.4%). Conclusion: In this setting of dyslipidemic patients, who have been difficult-to-control, rosuvastatin + lipid-lowering treatment achieved greater reduction in serum cholesterol than traditional statins, and increased the proportion of patients achieving target cholesterol within a 6-month period.