Published online Feb 20, 2017. doi: 10.5493/wjem.v7.i1.25
Peer-review started: November 10, 2016
First decision: December 1, 2016
Revised: December 10, 2016
Accepted: January 2, 2017
Article in press: January 3, 2017
Published online: February 20, 2017
To evaluate the presence of the so called “statin escape” phenomenon among hyperlipidemic subjects attending a lipid clinic.
This was a retrospective analysis of 1240 hyperlipidemic individuals followed-up for ≥ 3 years. We excluded those individuals meeting one of the following criteria: Use of statin therapy at baseline visit, discontinuation of statin treatment at most recent visit, change in statin treatment during follow-up and poor compliance to treatment. Statin escape phenomenon was defined as an increase in low-density lipoprotein cholesterol (LDL-C) levels at the most recent visit by > 10% compared with the value at 6 mo following initiation of statin treatment.
Of 181 eligible subjects, 31% exhibited the statin escape phenomenon. No major differences regarding baseline characteristics were found between statin escapers and non-statin escapers. Both escapes and non-escapes had similar baseline LDL-C levels [174 (152-189) and 177 (152-205) mg/dL, respectively]. In comparison with non-escapers, statin escapers demonstrated lower LDL-C levels at 6 mo after treatment initiation [88 (78-97) mg/dL vs 109 (91-129) mg/dL, P < 0.05], but higher levels at the most recent visit [103 (96-118) mg/dL vs 94 (79-114) mg/dL, P < 0.05].
These data confirm the existence of an escape phenomenon among statin-treated individuals. The clinical significance of this phenomenon remains uncertain.
Core tip: This was a retrospective study aiming to evaluate the presence of the so called “statin escape” phenomenon among hyperlipidemic subjects attending a lipid clinic and elucidate any potential confounding factors. This study confirms the limited bibliography reporting on statin escape phenomenon and its quite high prevalence. However, due to the small number of eligible participants, we were not able to identify potential predictors for the statin-escape phenomenon or establish an association between statin escape and incidence of cardiovascular disease. In this context, further investigation on the underlying pathophysiology of this phenomenon and its potential clinical ramifications is required.