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.
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