Effect of individualizing starting doses of a statin according to baseline LDL-cholesterol levels on achieving cholesterol targets: the achieve cholesterol targets fast with atorvastatin stratified titration (ACTFAST) study

Atherosclerosis
P MartineauACTFAST investigators

Abstract

To investigate whether selecting the starting dose of atorvastatin according to baseline and target (<2.6 mmol/L) LDL-cholesterol (LDL-C) values would allow high-risk subjects to achieve target LDL-C concentration within 12 weeks, with the initial dose or a single uptitration. Twelve-week, prospective, open-label trial that enrolled 2117 high-risk subjects (statin-free [SF] or statin-treated [ST]). Subjects with LDL-C >2.6 mmol/L (100mg/dL) but <or=5.7 mmol/L (220 mg/dL) were assigned a starting dose of atorvastatin (10, 20, 40 or 80 mg/day) based on LDL-C and status of statin use at baseline, with a single uptitration at 6 weeks, if required. There was no washout for ST subjects. At study end, 80% of SF (82%, 82%, 83% and 72% with 10, 20, 40 and 80 mg, respectively) and 59% of ST (60%, 61% and 51% with 20, 40 and 80 mg, respectively) subjects reached LDL-C target. In the ST group, an additional 21-41% reduction in LDL-C was observed over the statin used at baseline. Atorvastatin was well tolerated. This study confirms that individualizing the starting dose of atorvastatin according to baseline and target LDL-C values (i.e. the required LDL-C reduction), allows a large majority of high-risk subjects to achieve target safely, wi...Continue Reading

References

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Citations

Dec 25, 2009·Circulation. Cardiovascular Genetics·Deepak VooraGeoffrey S Ginsburg
Feb 17, 2009·International Journal of Cardiology·G F GensiniUNKNOWN Achieve Cholesterol Targets Fast withAtorvastatin Stratified Titration Investigators
Apr 1, 2008·European Journal of Pharmacology·Luis M Blanco-ColioJesús Egido
Apr 29, 2009·Journal of Clinical Pharmacology·Milan GuptaSubodh Verma
Sep 8, 2009·The American Journal of Cardiology·Hwee TeohUNKNOWN Guidelines Based Undertaking for Improvement in Dyslipidemia Related Events (GUIDE) Investigators
Jul 19, 2008·Journal of Cardiovascular Pharmacology and Therapeutics·Juan Carlos Ferrer-GarcíaAgustín Herrera-Ballester
Oct 21, 2006·Arteriosclerosis, Thrombosis, and Vascular Biology·Luis M Blanco-ColioUNKNOWN ACTFAST investigators
Jul 10, 2021·Journal of the American Heart Association·Anatoly LangerLawrence A Leiter

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