Low-density lipoprotein cholesterol in a global cohort of 57,885 statin-treated patients
| Autor: | Martin Horack, Heinz Drexel, Anselm K. Gitt, Baishali M. Ambegaonkar, François Chazelle, John J.P. Kastelein, Jean Ferrières, Dominik Lautsch, Vasilisa Sazonov, Philippe Brudi, Brecht Vanneste, Peter Bramlage |
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| Přispěvatelé: | ACS - Amsterdam Cardiovascular Sciences, Vascular Medicine |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Statin medicine.drug_class Down-Regulation Low density lipoprotein cholesterol Comorbidity 030204 cardiovascular system & hematology Risk Assessment 03 medical and health sciences 0302 clinical medicine Treatment targets Risk Factors Internal medicine Prevalence medicine Humans 030212 general & internal medicine Healthcare Disparities Aged Dyslipidemias business.industry Cholesterol LDL Middle Aged medicine.disease Cross-Sectional Studies Treatment Outcome Existing Treatment Cohort Physical therapy European atherosclerosis society Female Hydroxymethylglutaryl-CoA Reductase Inhibitors Cardiology and Cardiovascular Medicine business Very high risk Biomarkers Dyslipidemia |
| Zdroj: | Atherosclerosis, 255, 200-209. Elsevier Ireland Ltd |
| ISSN: | 0021-9150 |
| Popis: | 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. |
| Databáze: | OpenAIRE |
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