Demographic determinants of response to statin medications

The demographic characteristics of veterans with coronary artery disease or diabetes were studied to determine their correlation with achieving a low-density-lipoprotein (LDL) cholesterol concentration of <100 mg/dL.

The New Mexico Veterans Affairs Health Care System's outcomes database was queried for data on patients with coronary artery disease (CAD) or its equivalent (diabetes). All patients treated with statins between 1998 and 2008 were eligible for the study. The database was also queried for patients' race, age, sex, body mass index, and serum LDL cholesterol concentrations. Information regarding statin type, dosage, timing, and regimen adjustment was collected and analyzed.

A total of 5191 patients were included in analyses. Of these, 3629 reached the LDL cholesterol goal of <100 mg/dL. The mean ± S.D. baseline LDL cholesterol value of patients who met goal was lower than that of those who did not (p < 0.001). The probability of attaining the LDL cholesterol goal increased with age but tapered off as patients reached their 70s and 80s (p < 0.001). Women were less likely to reach the goal LDL cholesterol level (p < 0.001). Use of a statin before CAD diagnosis was associated with a higher rate of goal LDL cholesterol attainment (p = 0.03) than if no statin was used. Regimen adjustments were inversely associated with achieving goal LDL cholesterol (p < 0.001).

Lower LDL cholesterol level before treatment, older age, male sex, statin use before CAD diagnosis, the last statin medication used by a patient before the end of the study, higher dosages of simvastatin or lovastatin, and a lower number of medication adjustments were associated with achieving an LDL cholesterol concentration of <100 mg/dL.