Improvement in achievement of lipid targets in France: Comparison of data from coronary patients in the DYSIS and DYSIS II studies

Abstract

Hyperlipidaemia is a major contributor to the development of coronary heart disease (CHD), with a direct correlation between low-density lipoprotein cholesterol (LDL-C) and all-cause death [ 1 Wilson P.W. D'Agostino R.B. Levy D. Belanger A.M. Silbershatz H. Kannel W.B. Prediction of coronary heart disease using risk factor categories. Circulation. 1998; 97: 1837-1847 Crossref PubMed Scopus (7417) Google Scholar , 2 Stamler J. Daviglus M.L. Garside D.B. Dyer A.R. Greenland P. Neaton J.D. Relationship of baseline serum cholesterol levels in 3 large cohorts of younger men to long-term coronary, cardiovascular, and all-cause mortality and to longevity. JAMA. 2000; 284: 311-318 Crossref PubMed Scopus (460) Google Scholar ]. The cross-sectional, observational Dyslipidemia International Study (DYSIS) study [ 3 Gitt A.K. Drexel H. Feely J. Ferrieres J. Gonzalez-Juanatey J.R. Thomsen K.K. et al. Persistent lipid abnormalities in statin-treated patients and predictors of LDL-cholesterol goal achievement in clinical practice in Europe and Canada. Eur. J. Prev. Cardiol. 2012; 19: 221-230 Crossref PubMed Scopus (123) Google Scholar , 4 Gitt A.K. Lautsch D. Ambegaonkar B. Horack M. Ferrières J. Persistent high distance to recommended LDL-cholesterol-targets despite chronic statin treatment: results of DYSIS. J. Am. Coll. Cardiol. 2016; 67: 1934 Crossref Google Scholar ] was conducted between 2008 and 2012 in 26 countries. The study involved 57,885 patients aged ≥45 years treated in primary or secondary care and who had been on statin treatment for at least 3 months. In a previous examination of the first 12 countries included in DYSIS [ [3] Gitt A.K. Drexel H. Feely J. Ferrieres J. Gonzalez-Juanatey J.R. Thomsen K.K. et al. Persistent lipid abnormalities in statin-treated patients and predictors of LDL-cholesterol goal achievement in clinical practice in Europe and Canada. Eur. J. Prev. Cardiol. 2012; 19: 221-230 Crossref PubMed Scopus (123) Google Scholar ], half of the patients did not achieve their target LDL-C goals, as defined by the 2007 European Society of Cardiology (ESC) guidelines [ [5] Graham I. Atar D. Borch-Johnsen K. Boysen G. Burell G. Cifkova R. et al. European guidelines on cardiovascular disease prevention in clinical practice: executive summary: Fourth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur. Heart J. 2007; 28: 2375-2414 Crossref PubMed Scopus (1293) Google Scholar ]. Among the French cohort in DYSIS, 37.2% of the patients [ [6] Agence Française de Sécurité Sanitaire des Produits de Santé Prise en charge therapeutique du patient dyslipidémique. in: Recommandations. 2005 Google Scholar ] met the French recommendations on LDL-C control [ [7] Ferrieres J. Berard E. Crisan O. Bongard V. Residual dyslipidaemia after statin treatment in France: prevalence and risk distribution. Arch. Cardiovasc. Dis. 2010; 103: 302-309 Crossref PubMed Scopus (13) Google Scholar ]. These data from DYSIS demonstrate a substantial gap between guideline recommendations and achievement of LDL-C targets in practice.