eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
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SCImago Journal & Country Rank
4/2019
vol. 15
 
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abstract:
Clinical research

Attainment of cholesterol target values in Greece: results from the Dyslipidemia International Study II

Evangelos Liberopoulos
,
Loukianos Rallidis
,
Filio Spanoudi
,
Elena Xixi
,
Anselm Gitt
,
Martin Horack
,
Veronica Ashton
,
Philippe Brudi
,
Dominik Lautsch
,
Baishali Ambegaonkar
,
Moses Elisaf

Arch Med Sci 2019; 15 (4): 821–831
Online publish date: 2018/03/12
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Introduction
Current European guidelines recommend treatment with lipid-lowering therapy (LLT) to a low-density lipoprotein cholesterol (LDL-C) target of < 70 mg/dl for patients at very high risk. LDL-C target attainment and use of LLTs in these patients in Greece is not known.

Material and methods
The Dyslipidemia International Study (DYSIS) II was a multicenter observational study. The coronary heart disease (CHD) cohort was divided into two groups based on treatment status (on LLT for ≥ 3 months or not on LLT). The acute coronary syndrome (ACS) cohort was evaluated at the time of admission and again 120 ±15 days after admission.

Results
In the CHD cohort (n = 499), 457 (91.6%) patients were on LLT. The LDL-C target value was attained by 26.5% of LLT users. Statin monotherapy was used by 77.5% of treated patients, with a mean ± SD atorvastatin dose equivalent of 24 ±16 mg/day. In the ACS cohort (n = 200), 159 (79.5%) patients were on LLT at admission. Mean ± SD LDL-C levels were 108 ±40 mg/dl at admission and 86 ±25 mg/dl at follow-up. LDL-C target value attainment rates were 16.2% at admission and 25.0% at follow-up. At admission, statin monotherapy was used by 86.8% of treated patients. The mean ± SD atorvastatin dose equivalent increased from 20 ±14 mg/day at admission to 29 ±15 mg/day at follow-up. The statin dose was associated with higher odds of LDL-C target value attainment (OR = 1.05, 95% CI: 1.02–1.08).

Conclusions
The LDL-C target attainment by very high risk patients in Greece is suboptimal. Increasing the statin dose or combining it with non-statins may improve target value attainment.

keywords:

cardiovascular disease, acute coronary syndrome, cholesterol, low-density lipoproteins, statins, coronary heart disease

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