Atorvastatin therapy under clinical practice conditions - which LDL-C levels are achieved in patients at very high cardiovascular risk?

Abstract

Current information on the utilisation of atorvastatin under clinical practice conditions is limited. The cross sectional study DISCOVER documented in the period from June until December 2014 dose and effects on lipids in ambulatory patients at very high cardiovascular risk, who were treated with atorvastatin monotherapy (original drug or generics). Of 2625 patients (mean age 66.1 ± 10.8 years, 62.1 % males), 47.0 % had coronary heart disease (CHD), 25.1 % type 2 diabetes mellitus (DM), and 27.9 % CHD plus concomitant DM. Mean treatment duration on atorvastatin was 92.6 ± 109.6 weeks, mean atorvastatin dose at time of documentation was 27.9 ± 15.8 mg/d. Low-density lipoprotein cholesterol (LDL-C) < 70 mg/dL was achieved by 10.5 % of the total cohort (7.5 % in DM, 9.3 % in CHD, and 15.2 % in CHD+DM). In contrast, according to physicians' subjective assessment, 62.7 % of patients reached their individual LDL-C target (with small differences between groups). In conclusion, the LDL-C target level < 70 mg/dL as recommended by current guidelines is achieved only in a minority of atorvastatin treated patients at very high cardiovascular risk.