Achieving Low-Density Lipoprotein Cholesterol Goals in High-Risk Patients in Managed Care: Comparison of Rosuvastatin, Atorvastatin, and Simvastatin in the SOLAR Trial
OBJECTIVE To evaluate attainment of the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III low-density lipoprotein cholesterol (LDL-C) goal of less than 100 mg/dL with statin treatments in managed care patients at high risk for coronary heart disease. PATIENTS AND METHODS...
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| Veröffentlicht in: | Mayo Clinic proceedings 2007-05, Vol.82 (5), p.543-550 |
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| creator | Insull, William, MD Ghali, Jalal K., MD Hassman, David R., DO Ycas, Joseph W., PhD Gandhi, Sanjay K., PhD Miller, Elinor, MD |
| description | OBJECTIVE To evaluate attainment of the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III low-density lipoprotein cholesterol (LDL-C) goal of less than 100 mg/dL with statin treatments in managed care patients at high risk for coronary heart disease. PATIENTS AND METHODS In a randomized, open-label, multicenter trial (SOLAR [Satisfying Optimal LDL-C ATP III goals with Rosuvastatin]) performed at 145 US clinical centers from June 5, 2002 to July 12, 2004, high-risk men and women in a managed care population received typical starting doses of rosuvastatin (10 mg/d), atorvastatin (10 mg/d), or simvastatin (20 mg/d) for 6 weeks. Those who did not meet the LDL-C target of less than 100 mg/dL at 6 weeks had their dose titrated (doubled), and all patients were followed up for another 6 weeks. RESULTS A total of 1632 patients were randomized to 1 of the 3 treatment regimens. After 6 weeks, 65% of patients taking rosuvastatin reached the LDL-C target of less than 100 mg/dL vs 41% with atorvastatin and 39% with simvastatin ( P |
| doi_str_mv | 10.4065/82.5.543 |
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PATIENTS AND METHODS In a randomized, open-label, multicenter trial (SOLAR [Satisfying Optimal LDL-C ATP III goals with Rosuvastatin]) performed at 145 US clinical centers from June 5, 2002 to July 12, 2004, high-risk men and women in a managed care population received typical starting doses of rosuvastatin (10 mg/d), atorvastatin (10 mg/d), or simvastatin (20 mg/d) for 6 weeks. Those who did not meet the LDL-C target of less than 100 mg/dL at 6 weeks had their dose titrated (doubled), and all patients were followed up for another 6 weeks. RESULTS A total of 1632 patients were randomized to 1 of the 3 treatment regimens. After 6 weeks, 65% of patients taking rosuvastatin reached the LDL-C target of less than 100 mg/dL vs 41% with atorvastatin and 39% with simvastatin ( P <.001 vs rosuvastatin for both). After 12 weeks, 76% of patients taking rosuvastatin reached the LDL-C target of less than 100 mg/dL vs 58% with atorvastatin and 53% with simvastatin ( P <.001 vs rosuvastatin for both). Reductions in the LDL-C level, total cholesterol level, non-high-density lipoprotein cholesterol (non-HDL-C) level, and non-HDL-C/HDL-C ratio were significantly greater with rosuvastatin at both 6 and 12 weeks compared with the other statins. Adverse events were similar in type and frequency in all treatment groups, and only 3% of all patients discontinued treatment because of adverse events. No myopathy was observed, no clinically important impact on renal function was attributed to study medications, and clinically important increases in serum transaminases were rare. CONCLUSION In a managed care population, 10 mg of rosuvastatin treatment resulted in more patients reaching the NCEP ATP III LDL-C goal compared with 10 mg of atorvastatin and 20 mg of simvastatin, potentially reducing the need for titration visits.</description><identifier>ISSN: 0025-6196</identifier><identifier>EISSN: 1942-5546</identifier><identifier>DOI: 10.4065/82.5.543</identifier><identifier>PMID: 17493418</identifier><identifier>CODEN: MACPAJ</identifier><language>eng</language><publisher>England: Elsevier Inc</publisher><subject><![CDATA[Aged ; Atorvastatin ; Care and treatment ; Cholesterol ; Cholesterol, LDL - blood ; Coronary Disease - blood ; Coronary heart disease ; Creatinine - blood ; Evaluation ; Female ; Fluorobenzenes - administration & dosage ; Heptanoic Acids - administration & dosage ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage ; Hypertriglyceridemia - blood ; Hypertriglyceridemia - drug therapy ; Internal Medicine ; Male ; Managed Care Programs ; Measurement ; Middle Aged ; Pyrimidines - administration & dosage ; Pyrroles - administration & dosage ; Rosuvastatin ; Rosuvastatin Calcium ; Simvastatin ; Simvastatin - administration & dosage ; Sulfonamides - administration & dosage]]></subject><ispartof>Mayo Clinic proceedings, 2007-05, Vol.82 (5), p.543-550</ispartof><rights>Mayo Foundation for Medical Education and Research</rights><rights>2007 Mayo Foundation for Medical Education and Research</rights><rights>COPYRIGHT 2007 Elsevier, Inc.</rights><rights>Copyright Mayo Foundation for Medical Education and Research May 2007</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c476t-e8e2e7bccbaab3463c071948c9c6cdebaff0c7d093e05063fda88f7413ce16ea3</citedby><cites>FETCH-LOGICAL-c476t-e8e2e7bccbaab3463c071948c9c6cdebaff0c7d093e05063fda88f7413ce16ea3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.proquest.com/docview/216871999?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>314,780,784,27922,27923,64383,64385,64387,72239</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17493418$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Insull, William, MD</creatorcontrib><creatorcontrib>Ghali, Jalal K., MD</creatorcontrib><creatorcontrib>Hassman, David R., DO</creatorcontrib><creatorcontrib>Ycas, Joseph W., PhD</creatorcontrib><creatorcontrib>Gandhi, Sanjay K., PhD</creatorcontrib><creatorcontrib>Miller, Elinor, MD</creatorcontrib><creatorcontrib>Solar Study Group</creatorcontrib><creatorcontrib>SOLAR Study Group</creatorcontrib><title>Achieving Low-Density Lipoprotein Cholesterol Goals in High-Risk Patients in Managed Care: Comparison of Rosuvastatin, Atorvastatin, and Simvastatin in the SOLAR Trial</title><title>Mayo Clinic proceedings</title><addtitle>Mayo Clin Proc</addtitle><description>OBJECTIVE To evaluate attainment of the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III low-density lipoprotein cholesterol (LDL-C) goal of less than 100 mg/dL with statin treatments in managed care patients at high risk for coronary heart disease. PATIENTS AND METHODS In a randomized, open-label, multicenter trial (SOLAR [Satisfying Optimal LDL-C ATP III goals with Rosuvastatin]) performed at 145 US clinical centers from June 5, 2002 to July 12, 2004, high-risk men and women in a managed care population received typical starting doses of rosuvastatin (10 mg/d), atorvastatin (10 mg/d), or simvastatin (20 mg/d) for 6 weeks. Those who did not meet the LDL-C target of less than 100 mg/dL at 6 weeks had their dose titrated (doubled), and all patients were followed up for another 6 weeks. RESULTS A total of 1632 patients were randomized to 1 of the 3 treatment regimens. After 6 weeks, 65% of patients taking rosuvastatin reached the LDL-C target of less than 100 mg/dL vs 41% with atorvastatin and 39% with simvastatin ( P <.001 vs rosuvastatin for both). After 12 weeks, 76% of patients taking rosuvastatin reached the LDL-C target of less than 100 mg/dL vs 58% with atorvastatin and 53% with simvastatin ( P <.001 vs rosuvastatin for both). Reductions in the LDL-C level, total cholesterol level, non-high-density lipoprotein cholesterol (non-HDL-C) level, and non-HDL-C/HDL-C ratio were significantly greater with rosuvastatin at both 6 and 12 weeks compared with the other statins. Adverse events were similar in type and frequency in all treatment groups, and only 3% of all patients discontinued treatment because of adverse events. No myopathy was observed, no clinically important impact on renal function was attributed to study medications, and clinically important increases in serum transaminases were rare. CONCLUSION In a managed care population, 10 mg of rosuvastatin treatment resulted in more patients reaching the NCEP ATP III LDL-C goal compared with 10 mg of atorvastatin and 20 mg of simvastatin, potentially reducing the need for titration visits.</description><subject>Aged</subject><subject>Atorvastatin</subject><subject>Care and treatment</subject><subject>Cholesterol</subject><subject>Cholesterol, LDL - blood</subject><subject>Coronary Disease - blood</subject><subject>Coronary heart disease</subject><subject>Creatinine - blood</subject><subject>Evaluation</subject><subject>Female</subject><subject>Fluorobenzenes - administration & dosage</subject><subject>Heptanoic Acids - administration & dosage</subject><subject>Humans</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage</subject><subject>Hypertriglyceridemia - blood</subject><subject>Hypertriglyceridemia - drug therapy</subject><subject>Internal Medicine</subject><subject>Male</subject><subject>Managed Care Programs</subject><subject>Measurement</subject><subject>Middle Aged</subject><subject>Pyrimidines - administration & dosage</subject><subject>Pyrroles - administration & dosage</subject><subject>Rosuvastatin</subject><subject>Rosuvastatin Calcium</subject><subject>Simvastatin</subject><subject>Simvastatin - administration & dosage</subject><subject>Sulfonamides - administration & dosage</subject><issn>0025-6196</issn><issn>1942-5546</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><recordid>eNptkt1u0zAYhiMEYmUgcQXI4mDigBQ7P46zA6SowIZUNNSOY8t1vjTeHLvYTlGviNvEXQuDCfnA8qvn-_WbJC8JnhaYlu9YNi2nZZE_SiakLrK0LAv6OJlgnJUpJTU9SZ55f4Mxruq6eJqckKqo84KwSfKzkb2CrTJrNLc_0g9gvAo7NFcbu3E2gDJo1lsNPoCzGl1YoT2K4qVa9-lC-Vv0VQQFJtypX4QRa2jRTDg4RzM7bIRT3hpkO7SwftwKHyJu3qImWHf_EqZFSzX8FvapQg9oeTVvFujaKaGfJ0-6WBpeHO_T5Nunj9ezy3R-dfF51sxTWVQ0pMAgg2ol5UqIVV7QXOIqboTJWlLZwkp0HZZVi-sccIlp3rWCsa4qSC6BUBD5aXJ2yBun_z7GsfmgvASthQE7el7hgjFW5hF8_QC8saMzsTeeEcpi1bqO0PQArYUGrkxngxMynhYGJa2BTkW9ITSnLMN3Wc_-CuhB6NB7q8egrPH_gm8OoHTWewcd3zg1CLfjBPO9JzjLeMmjJyL66tjpuBqgvQePJohAdgAgLnarwHEv45dKaJUDGXhr1f-yvn8QJLUySgp9Czvwf5ZBuM845su9F_dWJISSrKJV_gs-ZdfW</recordid><startdate>20070501</startdate><enddate>20070501</enddate><creator>Insull, William, MD</creator><creator>Ghali, Jalal K., MD</creator><creator>Hassman, David R., DO</creator><creator>Ycas, Joseph W., PhD</creator><creator>Gandhi, Sanjay K., PhD</creator><creator>Miller, Elinor, MD</creator><general>Elsevier Inc</general><general>Elsevier, Inc</general><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>4U-</scope><scope>7RV</scope><scope>7T5</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>88I</scope><scope>8AF</scope><scope>8C1</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>AZQEC</scope><scope>BEC</scope><scope>BENPR</scope><scope>CCPQU</scope><scope>DWQXO</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9-</scope><scope>K9.</scope><scope>KB0</scope><scope>M0R</scope><scope>M0S</scope><scope>M1P</scope><scope>M2P</scope><scope>NAPCQ</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>Q9U</scope><scope>S0X</scope><scope>7X8</scope></search><sort><creationdate>20070501</creationdate><title>Achieving Low-Density Lipoprotein Cholesterol Goals in High-Risk Patients in Managed Care: Comparison of Rosuvastatin, Atorvastatin, and Simvastatin in the SOLAR Trial</title><author>Insull, William, MD ; Ghali, Jalal K., MD ; Hassman, David R., DO ; Ycas, Joseph W., PhD ; Gandhi, Sanjay K., PhD ; Miller, Elinor, MD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c476t-e8e2e7bccbaab3463c071948c9c6cdebaff0c7d093e05063fda88f7413ce16ea3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2007</creationdate><topic>Aged</topic><topic>Atorvastatin</topic><topic>Care and treatment</topic><topic>Cholesterol</topic><topic>Cholesterol, LDL - blood</topic><topic>Coronary Disease - blood</topic><topic>Coronary heart disease</topic><topic>Creatinine - blood</topic><topic>Evaluation</topic><topic>Female</topic><topic>Fluorobenzenes - administration & dosage</topic><topic>Heptanoic Acids - administration & dosage</topic><topic>Humans</topic><topic>Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage</topic><topic>Hypertriglyceridemia - blood</topic><topic>Hypertriglyceridemia - drug therapy</topic><topic>Internal Medicine</topic><topic>Male</topic><topic>Managed Care Programs</topic><topic>Measurement</topic><topic>Middle Aged</topic><topic>Pyrimidines - administration & dosage</topic><topic>Pyrroles - administration & dosage</topic><topic>Rosuvastatin</topic><topic>Rosuvastatin Calcium</topic><topic>Simvastatin</topic><topic>Simvastatin - administration & dosage</topic><topic>Sulfonamides - administration & dosage</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Insull, William, MD</creatorcontrib><creatorcontrib>Ghali, Jalal K., MD</creatorcontrib><creatorcontrib>Hassman, David R., DO</creatorcontrib><creatorcontrib>Ycas, Joseph W., PhD</creatorcontrib><creatorcontrib>Gandhi, Sanjay K., PhD</creatorcontrib><creatorcontrib>Miller, Elinor, MD</creatorcontrib><creatorcontrib>Solar Study Group</creatorcontrib><creatorcontrib>SOLAR Study Group</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>University Readers</collection><collection>ProQuest Nursing and Allied Health Source</collection><collection>Immunology Abstracts</collection><collection>Health Medical collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Science Database (Alumni Edition)</collection><collection>STEM Database</collection><collection>Public Health Database (ProQuest Medical & Health Databases)</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni)</collection><collection>ProQuest Central</collection><collection>ProQuest Central Essentials</collection><collection>eLibrary</collection><collection>ProQuest Central</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection (Proquest) (PQ_SDU_P3)</collection><collection>Consumer Health Database (Alumni Edition)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Database (Alumni Edition)</collection><collection>Family Health Database (ProQuest Medical & Health Databases)</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>PML(ProQuest Medical Library)</collection><collection>ProQuest Science Journals</collection><collection>Nursing & Allied Health Premium</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest Central Basic</collection><collection>SIRS Editorial</collection><collection>MEDLINE - Academic</collection><jtitle>Mayo Clinic proceedings</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Insull, William, MD</au><au>Ghali, Jalal K., MD</au><au>Hassman, David R., DO</au><au>Ycas, Joseph W., PhD</au><au>Gandhi, Sanjay K., PhD</au><au>Miller, Elinor, MD</au><aucorp>Solar Study Group</aucorp><aucorp>SOLAR Study Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Achieving Low-Density Lipoprotein Cholesterol Goals in High-Risk Patients in Managed Care: Comparison of Rosuvastatin, Atorvastatin, and Simvastatin in the SOLAR Trial</atitle><jtitle>Mayo Clinic proceedings</jtitle><addtitle>Mayo Clin Proc</addtitle><date>2007-05-01</date><risdate>2007</risdate><volume>82</volume><issue>5</issue><spage>543</spage><epage>550</epage><pages>543-550</pages><issn>0025-6196</issn><eissn>1942-5546</eissn><coden>MACPAJ</coden><abstract>OBJECTIVE To evaluate attainment of the National Cholesterol Education Program (NCEP) Adult Treatment Panel (ATP) III low-density lipoprotein cholesterol (LDL-C) goal of less than 100 mg/dL with statin treatments in managed care patients at high risk for coronary heart disease. PATIENTS AND METHODS In a randomized, open-label, multicenter trial (SOLAR [Satisfying Optimal LDL-C ATP III goals with Rosuvastatin]) performed at 145 US clinical centers from June 5, 2002 to July 12, 2004, high-risk men and women in a managed care population received typical starting doses of rosuvastatin (10 mg/d), atorvastatin (10 mg/d), or simvastatin (20 mg/d) for 6 weeks. Those who did not meet the LDL-C target of less than 100 mg/dL at 6 weeks had their dose titrated (doubled), and all patients were followed up for another 6 weeks. RESULTS A total of 1632 patients were randomized to 1 of the 3 treatment regimens. After 6 weeks, 65% of patients taking rosuvastatin reached the LDL-C target of less than 100 mg/dL vs 41% with atorvastatin and 39% with simvastatin ( P <.001 vs rosuvastatin for both). After 12 weeks, 76% of patients taking rosuvastatin reached the LDL-C target of less than 100 mg/dL vs 58% with atorvastatin and 53% with simvastatin ( P <.001 vs rosuvastatin for both). Reductions in the LDL-C level, total cholesterol level, non-high-density lipoprotein cholesterol (non-HDL-C) level, and non-HDL-C/HDL-C ratio were significantly greater with rosuvastatin at both 6 and 12 weeks compared with the other statins. Adverse events were similar in type and frequency in all treatment groups, and only 3% of all patients discontinued treatment because of adverse events. No myopathy was observed, no clinically important impact on renal function was attributed to study medications, and clinically important increases in serum transaminases were rare. CONCLUSION In a managed care population, 10 mg of rosuvastatin treatment resulted in more patients reaching the NCEP ATP III LDL-C goal compared with 10 mg of atorvastatin and 20 mg of simvastatin, potentially reducing the need for titration visits.</abstract><cop>England</cop><pub>Elsevier Inc</pub><pmid>17493418</pmid><doi>10.4065/82.5.543</doi><tpages>8</tpages></addata></record> |
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| ispartof | Mayo Clinic proceedings, 2007-05, Vol.82 (5), p.543-550 |
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| subjects | Aged Atorvastatin Care and treatment Cholesterol Cholesterol, LDL - blood Coronary Disease - blood Coronary heart disease Creatinine - blood Evaluation Female Fluorobenzenes - administration & dosage Heptanoic Acids - administration & dosage Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors - administration & dosage Hypertriglyceridemia - blood Hypertriglyceridemia - drug therapy Internal Medicine Male Managed Care Programs Measurement Middle Aged Pyrimidines - administration & dosage Pyrroles - administration & dosage Rosuvastatin Rosuvastatin Calcium Simvastatin Simvastatin - administration & dosage Sulfonamides - administration & dosage |
| title | Achieving Low-Density Lipoprotein Cholesterol Goals in High-Risk Patients in Managed Care: Comparison of Rosuvastatin, Atorvastatin, and Simvastatin in the SOLAR Trial |
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