The Continuation of the translation of article Makin Rendah LDL, Makin Baik Efeknya Terhadap Atherosklerosis

These guidelines are based on the research result that stated, the lower LDL cholesterol level is diminished, the lower cardiovascular happens. It is proved that the height of LDL cholesterol level relates to the thickness of media intima. Although it cant be proved obviously, to prevent serum LDL cholesterol atherosclerosis plaque has to be <70mg/dl, serum total cholesterol <150mg/dl, and high density lipoprotein cholesterol (HDL) >20mg/dl.

Statin and Atherosclerosis Statin medicines are the best cardiovascular medicine that has ever been created because it can prevent atherosclerosis plaque and its complication. Statin also has large potency to stop plaque formation so that it can avoid another atherosclerosis event. There are many proofs show, statin therapy has main priority to the extremely high risky patient, it retards atherosclerosis progression. The latest clinical research confirmed that the therapy for lipid reduction aggressively with statin can decrease LDL cholesterol below 100mg/dl to the extremely high risky patient. Consequently, it is an effective way to prevent cardiovascular event. There is relation directly between LDL cholesterol level and change to the thickness of carotid media intima and plaque size. In a research, 61% patient who has LDL cholesterol level below 70 shows the thickness regression of carotid media intima, compared 29% patient has LDL cholesterol level >114mg/dl. Another research shows the relation of positive linear, between plaque change percentage each year from cross sectional media area with LDL cholesterol level. A patient who has LDL cholesterol level >120mg/dl shows yearly plaque

aggression and bigger lumen reduction, compared with they have lower LDL cholesterol. This data indicates, the patient who reaches the National Cholesterol Education Program Adult Treatment Panel III for the highest risk patient, that is <70mg/dl more possibility to get cardiovascular regression. Livid reduction treatment with the statin decreases progression and megression of atheroklerosis, rather than the medical by using placebo. The approximation of the livid reduction aggressively can give huge benefits to atherosklerosis than the more moderate approximation. Post Coronary Artery Bypass Graft (POST-CABG) research is the first research that values directly the effect of aggressive statin treatment (the lovastatin with 76mg/day dose to achieve LDL cholesterol <500mg/dl) and moderate (lovastatin with 4mg/day dose to achieve LDL cholesterol <130mg/dl), at the atherosklerosis progress after doing bypass operation. Aggressive treatment versus moderate treatment associated with the reduction in the primary of end point of 31% and revascularitation procedure which is lower in the number of 29%. In addition, the incidence of lesions and the new grafts have a percentage significantly lower in patients who received aggressive treatment. Some research has extended the findings of post CABG in the patients with other condition using different measurement techniques. That become the attention now, whether it is needed to give statins to people with atherosclerosis, though the level of LDL is stil normal. For instance, low-risk patients who have cholesterol levels that are not too high are considered as the candidate to do the drug therapy. Whereas most of these low-risk patients actually have the subclinical atherosclerosis. The early detection and treatment can improve the prognosis of those patients.

Rosuvastatin Rosuvastatin, a kind of statin, has been widely used to treat dyslipidemia. Its lipidlowering efficacy has been widely investigated. Nowadays, the Rosuvastatin has had the agreement to be used in United States to slow down the atherosvlerosis progression as part of strategy to decrese LDL cholesterol levels and cholesterol total,until the desired level. Generally, Rosuvastatin decreases LDL cholesterol significantly bigger than simvastatin, pravastatin or atorvastatin at hypercholestrolemia patients, include high-risk patients, metabolic syndrome or diabetic dyslipidemia patients, African-America patients, Hispanic-America patients with moderate or high risk, and high-risk patients o South Asia. Generally, total cholesterol level decreases more significantly with rosuvastatin than simvastatin. Increased HDL cholesterol level is also biggest to the oatient which gets rosuvastatin than simvastatin or atorvastatin in many researches. Stellar Research shows clearly Rosuvastatin has better efficacy than atorvastatin, simvastatin, and pravastatin. Rosuvastatin 1040 mg decreases LDL cholesterol until 45,8-55,0% than 36,8-51,1% with atorvastatin 10-80 mg, 28,3-45,8%. While rosuvastatin 10 mg decreases LDL cholesterol is bigger significantly than pravastatin 10, 20, and 40 mg. Significantly, the patients in using rosuvastatin is greater in number than the patients who use atorvastatin which has attained LDL NCEP ATP III cholesterol target ( 69%-83% ) vs 63%72%. In 2003, The cholesterol target in Europe attain to 68%-96% vs 63%-87% and in 1998, it is about 79%-71% in 6-16 weeks. In addition, the LDL NCEP ATP III cholesterol target is more attained to patients who use rosuvastatin 84% and 65% than atorvastatin 75% and 41%.

Moreover the patients who run up the simvastatin in 6 and 24 weeks, in ECLIPSE and SOLAR researchers. In mercury research, in 1998 on the 16th weeks, the number of patients that reached the LDL cholesterol target significantly is greater than those who substitute their medicines to rosuvastatin for 10mg/day rather than patients who still consume atorvastatin for 10mg/day, 86% vs 80%, simvastatin 20mg/day 86% vs 72% or pravastatin 40mg/day 88% vs 66% and for patients who change it to rosuvastatin 20mg/day comparing to the patients who still use the atorsvastatin 20mg/day 90% vs 84%. This inequality is not significant. On the 16th weeks in MERCURY II research, the number of patients who attained LDL NCEP ATP III cholesterol target is significantly greater than those who have changed the treatment to rosuvastatin 20mg/day than those who keep using atorvastatin 10mg/day 66% vs 42% or simvastatin 20mg/day ( 73% vs 32% ) By Group: Debbie Natalia ( 15100010 ) Duhita Kumala ( 15100019 ) Ervita Buntara ( 15100003 ) F. Agnes Petronella ( 15100036 ) Julia Hartanti ( 15100024 ) Lisna Romauli ( 15100042 )