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Cardiology. 2013;125(3):154-63. doi: 10.1159/000348859. Epub 2013 Jun 1.

Total lipid management and cardiovascular disease in the dyslipidemia international study.

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  • 1Department of Cardiology, Toulouse Rangueil University Hospital, Toulouse, France. jean.ferrieres@univ-tlse3.fr

Abstract

OBJECTIVES:

Despite statin use, many patients with cardiovascular disease (CVD) are not achieving treatment goals. An international observational study was performed to estimate the prevalence of residual lipid abnormalities in statin-treated patients with CVD to assess whether lipid management requires improvement.

METHODS:

Fasting plasma concentrations of low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides were recorded in 11,104 patients with atherosclerotic CVD and ≥3 months of statin therapy.

RESULTS:

LDL-C and total cholesterol were not at goal levels in 41 and 46% of all patients, respectively; for patients with peripheral artery disease (PAD) only, 59 and 65%, respectively, were not at goal, and in those with coronary heart disease only, 38 and 42%, respectively, were not at goal. Patients with cerebrovascular disease only were least frequently observed to have low HDL-C (24%) and elevated triglycerides (36%). Overall, elevated LDL-C was the most frequent lipid anomaly observed, and preexisting heart failure was strongly and positively associated with dyslipidemia.

CONCLUSIONS:

Approximately two fifths of statin-treated patients with CVD are not reaching lipid goals or have abnormal lipid levels, while patients with PAD could particularly benefit from improved lipid management. In addition to targeting LDL-C, new evidence-based approaches are needed to target low HDL-C and elevated triglycerides.

Copyright © 2013 S. Karger AG, Basel.

PMID:
23736147
[PubMed - indexed for MEDLINE]
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