eISSN: 1896-9151
ISSN: 1734-1922
Archives of Medical Science
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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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