Low-density lipoprotein cholesterol in a global cohort of 57,885 statin-treated patients

被引：90

作者：

Gitt, Anselm K. ^{[1
,2
]}

Lautsch, Dominik ^{[3
]}

Ferrieres, Jean ^{[4
]}

Kastelein, John ^{[5
]}

Drexel, Heinz ^{[6
,7
,8
,9
]}

Horack, Martin ^{[2
]}

Brudi, Philippe ^{[3
]}

Vanneste, Brecht ^{[3
]}

Bramlage, Peter ^{[10
]}

Chazelle, Francois ^{[3
]}

Sazonov, Vasilisa ^{[3
]}

Ambegaonkar, Baishali ^{[3
]}

机构：

[1] Klinikum Stadt Ludwigshafen, Med Klin B, Ludwigshafen, Germany

[2] Stiftung Inst Herzinfarktforsch, Bremser Str 79, D-67063 Ludwigshafen, Germany

[3] Merck & Co Inc, Kenilworth, NJ USA

[4] Toulouse Univ, Sch Med, Toulouse, France

[5] Univ Amsterdam, Acad Med Ctr, Dept Vasc Med, Amsterdam, Netherlands

[6] Acad Teaching Hosp Feldkirch, Dept Med & Cardiol, Feldkirch, Austria

[7] VIVIT, Feldkirch, Austria

[8] Private Univ Principal Liechtenstein, Triesen, Liechtenstein

[9] Drexel Univ, Coll Med, Philadelphia, PA 19104 USA

[10] Inst Pharmacol & Prevent Med, Mahlow, Germany

来源：

ATHEROSCLEROSIS | 2016年 / 255卷

关键词：

Cardiovascular disease (CVD); Dyslipidemia; Statins; Low-density lipoprotein cholesterol (LDL-C); Treatment targets; CORONARY-HEART-DISEASE; LIPID-LOWERING THERAPY; CARDIOVASCULAR-DISEASE; CLINICAL-PRACTICE; MYOCARDIAL-INFARCTION; EUROPEAN GUIDELINES; RANDOMIZED-TRIALS; ATORVASTATIN; PREVENTION; RISK;

D O I：

10.1016/j.atherosclerosis.2016.09.004

中图分类号：

R5 [内科学];

学科分类号：

100201 [内科学];

摘要：

Background and aims: There is an inconsistency between international guidelines on lipid-lowering treatment regarding whether to pursue LDL-C treatment targets or to focus on the intensity of treatment. While either approach is attractive, there is no recent global data on actual LDL-C values, treatment targets attained, and the intensity of treatment in statin-treated patients. We aimed to determine and compare the extent of treatment target attainment globally using standardized data collection. Methods: Analyses were based on the Dyslipidemia International Study (DYSIS), a cross-sectional study documenting statin-treated outpatients throughout 30 countries worldwide (across Europe, the Middle East, Canada, Africa, and Asia). Patients were classified as being at very high, high, or non-high cardiovascular risk based on the 2011 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines. Results: Data were available for a total of 57,885 patients with a median LDL-C value of 98.2 mg/dl (IQR: 76.6, 125.7 mg/dl). Overall, only 26.8% of patients were documented to have attained their risk-based target LDL-C level. Of the 76% of patients who were classified as being at very high risk, only 21.7% attained their LDL-C goal. Globally, the median distance to target was 33.0 mg/dl, ranging from 18.8 to 42.1 mg/dl across countries. We calculated that a further LDL-C reduction of just 10 mg/dl would result in an 11% increase in the proportion of very-high-risk and high-risk patients attaining their target level (9% for non-high risk patients). Conclusions: In spite of statin therapy, LDL-C values were high, with a substantial distance to target that was even more pronounced in (very) high risk patients. These results call for the optimization of existing treatment strategies and a collaborative effort to improve the impact of treatment guidance on clinical practice. (C) 2016 Elsevier Ireland Ltd. All rights reserved.

引用

页码：200 / 209

页数：10

共 48 条

[1]

Efficacy and safety of more intensive lowering of LDL cholesterol: a meta-analysis of data from 170 000 participants in 26 randomised trials [J].