0191: Poor achievement of low-density lipoprotein cholesterol targets in French patients with stable coronary heart disease. Contemporary data from DYSIS II CHD study

Abstract

We sought to determine achievement of lipid targets according to current European guidelines (low-density lipoprotein cholesterol [LDL-C] ≤70mg/dL) in patients with stable coronary heart disease (CHD) with or without lipid-lowering therapy (LLT), in the French cohort of the Dyslipidemia International Study II CHD (DYSIS II CHD ). DYSIS II CHD was a multicentre observational cross-sectional study conducted from July 2013 to October 2014 in 27 centres in France. Adults with stable CHD (defined as ≥1 of the following: >50% stenosis on coronary angiography or computed tomography, prior percutaneous coronary intervention, prior coronary bypass graft, history of ACS >3 months previously) and a fasting lipid profile done within the previous 12 months were consecutively enrolled. Eligible patients had to be on LLT for ≥3 months or taking no LLT. A total of 436 CHD patients were enrolled. Of the 424 patients (97.2%) on LLT, 91.5% were on statin treatment at the moment of inclusion (mean±SD dose calculated in atorvastatin 27±23mg/day). Non-statin LLT was used in 17.7% patients (79.2% were on a cholesterol-absorption inhibitor). Mean±SD LDL-C was 87.4±30.5mg/dL, 28.4% achieved LDL-C<70mg/dL, and 67.7% had an LDL-C<100mg/dL (Table). Abstract 0191 – Table: Characteristics of lipid values in patients with stable CHD All patients (n=436) LLT (n=424) No LLT (n=12) Age (years) 69±12 69±12 74±12 Men 80.0 79.7 91.7 ACS >3 months previously 70.0 70.0 66.7 Diabetes type 2 27.0 27.3 16.7 Chronic kidney disease 5.0 5.2 0 Lipid variables LDL-C (mg/dL) 87.4±30.5 86.0±29.6 135.3±24.5 ** LDL <70 mg/dL 28.4 29.2 0 * Distance to target of <70 mg/dL (mg/dL) 31.1±24.2 29.7±23.2 65.3±24.5 ** LDL <100 mg/dL 67.7 69.3 8.3 ** Data are mean±SD or %. * P<0.05 ** P?0.0001 (LLT vs no LLT) These observational data from contemporary clinical practice in France indicate suboptimal lipid control, with over two-thirds of high-risk CHD patients failing to achieve the LDL-C target despite taking LLT, and a large difference between mean value and target LDL-C. More-intensive treatment is required to optimize achievement of lipid goals in CHD.