An assessment of the efficacy of atorvastatin in achieving LDL cholesteroltarget levels in patients with coronary heart disease: A general practice study

Adherence to evidence-based guidelines for the secondary prevention of coro nary heart disease (CHD) has been shown to be poor in a number of surveys. In this open-label, non-comparative 17-week trial, 399 patients with existi ng CHD and LDL cholesterol concentration >3.4 mmol/l (130 mg/dl) were treat ed with atorvastatin 10 mg daily. After 5 weeks, the dose of atorvastatin w as adjusted according to a patient's LDL cholesterol level. Of the 379 pati ents remaining in the study after five weeks of treatment, dose titration w as not required for 355 patients (94%) who had reached the target LDL chole sterol of less than or equal to 3.4 mmol/l. Of the 23 patients titrated to higher doses, 11 achieved the target LDL cholesterol after treatment for 17 weeks. Atorvastatin was well tolerated during the course of the study. Ach ieving LDL cholesterol targets without the need for dose titration simplifi es clinical management and should encourage better adherence to evidence-ba sed recommendations for secondary prevention of CHD.