How do statins compare in their ability to reduce LDL-c?
For patients who require LDL-c reductions of up to 35% to meet their goal, any of the statins are effective. In patients requiring an LDL-c reduction of 35% to 50% to meet the NCEP goal, atorvastatin 20mg or more, lovastatin 80mg, rosuvastatin 10mg or more, and simvastatin 20mg or more daily are likely to meet the goal. Among high-potency statins, Atorvastatin 80mg daily and rosuvastatin 20mg or more reduced LDL-C by 50% or more. Atorvastatin 80mg had a higher rate of some adverse effects (GI disturbances and transaminase elevation) than simvastatin 80mg daily in a trial in which the LDL lowering of atorvastatin was greater than that of simvastatin. Adverse event rates in patients using rosuvastatin 40mg were similar to rates in patients using atorvastatin 80mg in short-term trials.
