Lipid goal attainment in post-acute coronary syndrome patients in China: Results from the 6-month real-world dyslipidemia international study II.

Abstract

BackgroundDyslipidemia International Study II (DYSIS II)‐China was conducted to determine the low‐density lipoprotein cholesterol (LDL‐C) goal (<1.8 mmol/L) attainment rate in patients with post‐acute coronary syndrome (ACS).HypothesisCompliance with treatment guideline recommendations improves the LDL‐C goal attainment rate in post‐ACS patients.MethodsThis multicenter prospective observational study conducted at 28 tertiary hospitals determined the LDL‐C goal attainment rates at admission and 6‐month follow‐up in patients on lipid‐lowering treatment (LLT) for ≥3 months and those not on LLT (LLT‐naive or off LLT for ≥3 months) at admission. Predictors of goal attainment at 6 months were identified using multivariate logistic regression.ResultsThe LDL‐C goal attainment rate at admission in 1102/1103 enrolled patients was 17.1%; it was 41.2% among 752 patients with available lipid results at 6 months. The distance to goal was 0.7 mmol/L at 6 months. Statin monotherapy was the most prescribed LLT. Only 7.7% of patients were receiving statin + ezetimibe and 8.4% of patients were receiving an atorvastatin‐equivalent dose of ≥40 mg/day at 6 months. Being male (odds ratio [OR] 1.7, 95% confidence interval [CI] 1.1–2.6) and undergoing percutaneous coronary intervention during index hospitalization (OR 1.5, 95% CI 1.1 to 2.1) were the independent predictors for LDL‐C goal attainment.ConclusionsThis real‐world DYSIS II study in China reports a low LDL‐C goal attainment rate in post‐ACS patients even after 6 months of LLT. Lack of intensification of statin therapy and underutilization of combinations suggest gaps between real‐world treatment practices and guideline recommendations.