Achievement Rates of Japan Atherosclerosis Society Guidelines 2007 LDL- Cholesterol Goals with Rosuvastatin or Atorvastatin in Patients Who Had Not Achieved Their Goal with Atorvastatin

BackgroundThe Japan Atherosclerosis Society's 2007 Guidelines for Prevention of Atherosclerotic Cardiovascular Diseases (JAS2007GL) advocate reducing LDL cholesterol (LDL-C) to target levels in patients with dyslipidemia, but achievement rates are frequently unsatisfactory even in the presence of lipid-lowering therapy. This multicenter, open-label, randomized, parallel-group study compared the efficacy of rosuvastatin and atorvastatin on JAS2007GL LDL-C goals in Japanese patients not achieving their target goal with atorvastatin treatment. MethodsThe study involved 20 clinical institutes in Japan (Kishiwada Atherosclerosis Prevention Study [KAPS] Group). Patients with category II or III risk of coronary artery disease (CAD), or those with a history of CAD (secondary prevention), who had not achieved their JAS2007GL LDL-C goals during treatment with atorvastatin for at least 4weeks were switched either to rosuvastatin 5mg/day (from atorvastatin 10mg/day) or rosuvastatin 10mg/day (from atorvastatin 20mg/day) (n=75) or continued to receive atorvastatin (n=77). The primary endpoint was achievement of LDL-C goals at 3months. The main secondary endpoint was achievement of LDL-C goal + high-sensitivity C-reactive protein level <1.0mg/L at 3months. ResultsAchievement rates for the primary endpoint were 49.3% in the rosuvastatin group and 31.7% in the atorvastatin group (P=0.022). Achievement rates for the main secondary endpoint were 40.0% in the rosuvastatin group and 20.8% in the atorvastatin group (P=0.010). Rosuvastatin and atorvastatin were both well tolerated in this study. ConclusionsRosuvastatin is a useful treatment option for Japanese patients who are not achieving their JAS2007GL LDL-C goal with atorvastatin.