The effect of decreasing statin's dosage on LDL-C levels after target levels achieved.

OBJECTIVE Evidences from clinical trials had demonstrated that statins reduce the risk of cardio-cerebral vascular events. But lipid lowering therapy (LLT) was suboptimal in stroke patients and clinically, observation of reducing the dosage of statins is common when target low density lipoprotein cholesterol (LDL-C) level achieved. We aim to explore the changes in lipid profile after reducing statin's dosage when target LDL-C level achieved. METHODS One hundred and three consecutive stroke patients follow up at out-patient clinic (44 women, 59 men) were recruited. Twenty two patients had their statin's dosage decreased to half while eighty one patients had their initial statin's dosage maintained after target LDL-C (less than 100mg/dL) level achieved. Lipid profile before and after LLT adjustment were compared. RESULTS The follow-up LDL-C level was significant higher while the percentage of patients with LDL-C level less than 100 mg/dL was significant lower in patients with statin's dosage decreased. For all patients, regardless the adjustment of LLT, the percentage of patients with LDL-C level less than 100 mg/dL was significant lower in follow- up lipid profile comparing with the baseline, but only the follow-up total cholesterol and LDL-C level were significant higher in the patients group with reduced statin's dosage. No significant change was found in follow-up high density-lipoprotein cholesterol and triglyceride level in either group. CONCLUSION More patients had LDL-C level more than 100 mg/dL after dosage of statins decreased. We suggested that only for absolute contraindication or adverse effects of statins should we adjust LLT, it is better to maintain the dosage of statins after target level achieved. The impact of lipid profile changed after LLT adjustment on clinical outcomes needs further studied.