Cholesterol target value attainment and lipid-lowering therapy in patients with stable or acute coronary heart disease: Results from the Dyslipidemia International Study II
Journal
Atherosclerosis
Journal Volume
266
Pages
158-166
Date Issued
2017
Author(s)
Gitt A.K.
Lautsch D.
Ferri?res J.
De Ferrari G.M.
Vyas A.
Baxter C.A.
Bash L.D.
Ashton V.
Horack M.
Almahmeed W.
Poh K.K.
Brudi P.
Ambegaonkar B.
Abstract
Background and aims Low-density lipoprotein cholesterol (LDL-C) is a major contributor to cardiovascular disease. In the Dyslipidemia International Study II (DYSIS II), we determined LDL-C target value attainment, use of lipid-lowering therapy (LLT), and cardiovascular outcomes in patients with stable coronary heart disease (CHD) and those suffering from an acute coronary syndrome (ACS). Methods DYSIS II included patients from 18 countries. Patients with either stable CHD or an ACS were enrolled if they were ?18 years old and had a full lipid profile available. Data were collected at a physician visit (CHD cohort) or at hospital admission and 120 days later (ACS cohort). Results A total of 10,661 patients were enrolled, 6794 with stable CHD and 3867 with an ACS. Mean LDL-C levels were low at 88 mg/dl and 108 mg/dl for the CHD and ACS cohorts respectively, with only 29.4% and 18.9% displaying a level below 70 mg/dl. LLT was utilized by 93.8% of the CHD cohort, with a mean daily statin dosage of 25 ± 18 mg. The proportion of the ACS cohort treated with LLT rose from 65.2% at admission to 95.6% at follow-up. LLT-treated patients, who were female, obese, or current smokers, were less likely to achieve an LDL-C level of <70 mg/dl, while those with type 2 diabetes, chronic kidney disease, or those taking a higher statin dosage were more likely. Conclusions Few of these very high-risk patients achieved the LDL-C target, indicating huge potential for improving cardiovascular outcome by use of more intensive LLT. ? 2017
Subjects
Acute coronary syndrome; Cholesterol; Coronary heart disease; Dyslipidemias; Hydroxymethylglutaryl-CoA reductase inhibitors; LDL; Myocardial infarction; Unstable angina
SDGs
Other Subjects
atorvastatin; ezetimibe; low density lipoprotein cholesterol; rosuvastatin; simvastatin; antilipemic agent; biological marker; hydroxymethylglutaryl coenzyme A reductase inhibitor; low density lipoprotein cholesterol; acute coronary syndrome; adult; aged; Article; cholesterol blood level; chronic kidney failure; cohort analysis; controlled study; female; gender; high risk patient; hospital admission; hospital readmission; human; intermediate risk patient; ischemic heart disease; low risk patient; major clinical study; male; non insulin dependent diabetes mellitus; obesity; observational study; priority journal; prospective study; sedentary lifestyle; smoking; stable angina pectoris; acute coronary syndrome; Asia; blood; clinical trial; combination drug therapy; comorbidity; coronary artery disease; dyslipidemia; Europe; lifestyle; middle aged; Middle East; multicenter study; risk factor; sex factor; time factor; treatment outcome; Acute Coronary Syndrome; Aged; Asia; Biomarkers; Cholesterol, LDL; Comorbidity; Coronary Disease; Drug Therapy, Combination; Dyslipidemias; Europe; Female; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors; Hypolipidemic Agents; Life Style; Male; Middle Aged; Middle East; Prospective Studies; Risk Factors; Sex Factors; Time Factors; Treatment Outcome
Type
journal article