Achievement of combined goals of low-density lipoprotein cholesterol and non-high-density lipoprotein cholesterol with three different statins: Results from VOYAGER

Background: Guidelines suggest that the combination of low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C) is the most clinically relevant goal for lipid-lowering treatments. Methods: Data from VOYAGER, an individual patient data meta-analysis including 32,258 patients from 37 clinical trials, was used to determine the percentage of patients reaching combined goals of LDL-C and non-HDL-C following treatment with simvastatin, atorvastatin, or rosuvastatin. Paired comparisons were made between each dose of rosuvastatin and the same or higher doses of simvastatin and atorvastatin. Results: Each dose of rosuvastatin brought significantly more patients to the combined goal of LDL-C <. 100. mg/dL and non-HDL-C <. 130. mg/dL than the same or double dose of atorvastatin; atorvastatin 80. mg was significantly superior to rosuvastatin 10. mg (all p. <. 0.001). Each dose of rosuvastatin helped significantly more patients reach the combined goal than any dose of simvastatin (all p. <. 0.001), except for rosuvastatin 10. mg versus simvastatin 80. mg (non-significant). Also, each dose of rosuvastatin helped significantly more patients to reach the combined goal of LDL-C <. 70. mg/dL and non-HDL-C <. 100. mg/dL than the same or double dose of atorvastatin (all p. <. 0.001). Every dose of rosuvastatin was significantly superior to all doses of simvastatin (all p. ≤. 0.020), except for rosuvastatin 10. mg versus simvastatin 40. mg and 80. mg (non-significant). Conclusions: Physicians' choice of statin and dose is important in helping patients achieve the combined LDL-C and non-HDL-C goals recommended in established guidelines.