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J Am Coll Cardiol, 2007; 50:409-418, doi:10.1016/j.jacc.2007.02.073 (Published online 31 July 2007).
© 2007 by the American College of Cardiology Foundation
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Effect of the Magnitude of Lipid Lowering on Risk of Elevated Liver Enzymes, Rhabdomyolysis, and Cancer

Insights From Large Randomized Statin Trials

Alawi A. Alsheikh-Ali, MD, Prasad V. Maddukuri, MD, Hui Han, MD and Richard H. Karas, MD, PhD1,*

Molecular Cardiology Research Institute and Division of Cardiology, Department of Medicine, Tufts-New England Medical Center and Tufts University School of Medicine, Boston, Massachusetts.


Figure 1
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  		Figure 1 Relationship Between Rates of Elevated Liver Enzymes and % LDL-C Reduction

The sizes of the open circles represent the relative sizes of the statin treatment arms (i.e., number of patients in each arm). LDL-C = low-density lipoprotein cholesterol.

 

Figure 2
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  		Figure 2 Relationship Between Rates of Rhabdomyolysis and % LDL-C Reduction

The sizes of the open circles represent the relative sizes of the statin treatment arms (i.e., number of patients in each arm). LDL-C = low-density lipoprotein cholesterol.

 

Figure 3
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  		Figure 3 Rate of Elevated Liver Enzymes by Statin Dose Category

Rate of elevated liver enzymes per 100,000 person-years for each 10% reduction in low-density lipoprotein cholesterol (LDL-C) for the following statin dose categories: low dose (lovastatin 20 mg, simvastatin 20 mg, and atorvastatin 10 mg), intermediate dose (lovastatin 40 mg, simvastatin 40 mg, and pravastatin 40 mg), and high dose (lovastatin 80 mg, simvastatin 80 mg, fluvastatin 80 mg, and atorvastatin 80 mg).

 

Figure 4
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  		Figure 4 Rate of Elevated Liver Enzymes by Lovastatin Dose Category

Rate of elevated liver enzymes per 100,000 person-years for each 10% reduction in low-density lipoprotein cholesterol (LDL-C) for low-dose (20 mg), intermediate-dose (40 mg), and high-dose (80 mg) lovastatin.

 

Figure 5
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  		Figure 5 Rate of Elevated Liver Enzymes by Simvastatin Dose Category

Rate of elevated liver enzymes per 100,000 person-years for each 10% reduction in low-density lipoprotein cholesterol (LDL-C) for low-dose (20 mg), intermediate-dose (40 mg), and high-dose (80 mg) simvastatin.

 

Figure 6
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  		Figure 6 Rate of Elevated Liver Enzymes by Atorvastatin Dose Category

Rate of elevated liver enzymes per 100,000 person-years for each 10% reduction in low-density lipoprotein cholesterol (LDL-C) for low-dose (10 mg) and high-dose (80 mg) atorvastatin.

 

Figure 7
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  		Figure 7 Relationship Between Rates of Newly Diagnosed Cancer per 100,000 Person-Years and % LDL-C Reduction

The sizes of the open circles represent the relative sizes of the statin treatment arms (i.e., number of patients in each arm). BID = twice daily; LDL-C = low-density lipoprotein-cholesterol; QD = once daily. See text for trial acronym definitions.

 

Figure 8
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  		Figure 8 Relationship Between Rates of Newly Diagnosed Cancer per 100,000 Person-Years and Absolute LDL-C Reduction

The sizes of the open circles represent the relative sizes of the statin treatment arms (i.e., number of patients in each arm). Abbreviations as in Figure 7.

 

Figure 9
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  		Figure 9 Relationship Between Rates of Newly Diagnosed Cancer per 100,000 Person-Years and Achieved LDL-C Level

The sizes of the open circles represent the relative sizes of the statin treatment arms (i.e., number of patients in each arm). Abbreviations as in Figure 7.

 

Figure 10
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  		Figure 10 Rate of Newly Diagnosed Cancer by Statin Dose Category

Rate of newly diagnosed cancer per 100,000 person-years for each 10% reduction in low-density lipoprotein-cholesterol (LDL-C) for the following statin dose categories: low dose (lovastatin 20 mg), intermediate dose (lovastatin 40 mg, simvastatin 40 mg, and pravastatin 40 mg), and high dose (lovastatin 80 mg, fluvastatin 80 mg).

 




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