LDL-CHOLESTEROL LOWERING WITH ATORVASTATIN, ROSUVASTATIN AND SIMVASTATIN: RESULTS OF A RETROSPECTIVE OBSERVATIONAL...

Reduction of low-density lipoprotein cholesterol (LDL-C) is a central strategy in the primary and secondary prevention of cardiovascular disease. Statins are the most widely prescribed lipid-lowering agents. However, real-world evidence comparing their relative effectiveness in primary health care settings in middle-income countries remains limited.

To evaluate and compare the pharmacological effectiveness of atorvastatin, rosuvastatin, and simvastatin in reducing LDL-cholesterol and to assess the impact of combination therapy with ezetimibe on achieving LDL therapeutic targets in routine clinical practice.

A retrospective observational study was conducted at the Main Family Medicine Center in Ferizaj between January 1 and December 1, 2025. A total of 1,100 adult patients (≥18 years) receiving statin therapy for at least three months were included. Baseline and follow-up LDL-cholesterol levels were analyzed at individual and intergroup levels. Statistical analysis included parametric and non-parametric tests according to data distribution, analysis of variance (ANOVA) for between-group comparisons, and binary logistic regression to identify predictors of LDL target achievement. A p-value <0.05 was considered statistically significant.

Rosuvastatin was associated with the greatest mean reduction in LDL-cholesterol, followed by atorvastatin, while simvastatin demonstrated lower effectiveness. Differences between treatment groups were statistically significant (ANOVA, p<0.001). Patients receiving combination therapy with a statin plus ezetimibe were significantly more likely to achieve LDL therapeutic targets compared with those on statin monotherapy (OR>1, p<0.01). Multivariate analysis identified statin type and treatment intensity as independent predictors of LDL-cholesterol reduction.

Rosuvastatin and atorvastatin were associated with greater LDL-cholesterol reduction compared with simvastatin in primary health care. Combination therapy with ezetimibe significantly increased the likelihood of achieving therapeutic LDL targets.