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Low-density lipoprotein cholesterol target attainment in patients with stable or acute coronary heart disease.

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eMediNexus    13 September 2018

The goal of a new study published in the European Journal of Preventive Cardiology was to establish accurate data on cardiovascular disease risk factors, such as hyperlipidemia, in the Asia-Pacific region. This study design was that of an observational study - Dyslipidemia International Study (DYSIS) II, which was formulated to quantify the extent of hyperlipidemia in adults with acute and stable coronary heart disease globally. The study assessed lipid-lowering therapy and low-density lipoprotein cholesterol target attainment (<70 mg/dL) in 4,592 patients who had a stable coronary heart disease or who had suffered an acute coronary syndrome, across nine Asia-Pacific countries between July 2013 and October 2014. Among the participants, 2,794 had stable coronary heart disease and 1,798 were admitted with an acute coronary syndrome. It was found that in patients with stable coronary heart disease, the mean low-density lipoprotein cholesterol (LDL-C) level was 86.9 mg/dL; 91.7% of these patients were on lipid-lowering therapy, 31% achieved LDL-C level of less than 70 mg/dL. Whereas, in patients who had had an acute coronary syndrome, the corresponding values on hospitalization were 103.2 mg/dL, 63.4%, and 23.0%, respectively. Thus, target attainment was significantly higher in the lipid-lowering therapy-treated than non-treated patients in each cohort. On the other hand, mean atorvastatin-equivalent dosages were found to be low, with little use of non-statin adjuvants. Additionally, LDL-C target attainment showed improvements in patients with acute coronary syndrome during follow-up, but its rate remained low. Hence, it was inferred that many patients in Asia who are at very high risk of recurrent cardiovascular events have LDL-C levels above the recommended target. It was inferred that although lipid-lowering therapy is common, it is not being not used to its full potential.

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