Persistent dyslipidemia in Chinese patients treated with lipid-lowering drugs: interim results of the dyslipidaemia international study (DYSIS) China

Abstract

Purpose: To investigate the prevalence of persistent lipid abnormalities in Chinese patients treated with Lipid-Lowing Drug (LLD) in the real world setting. Methods: This cross-sectional study enrolled 25,397 consecutive outpatients aged 45 years and above who had received at least 3 months of LLD from 120 various tiers of hospitals across China. Patient demographics, medical history, recent lipid measurements and treatments were recorded. Patient's total cardiovascular (CV) risk categories and corresponding treatment goals for LDL-C and TC were defined based on the Chinese Adult Dyslipidemia Guideline 2007. Multivariate logistic regressions assessed the relationship between patient characteristics and LDL-C goal attainment. Result: A total of 6386 subjects were included in this interim analysis. The mean age was 65.5±10.23 years, 50.5% were males, 19.5% had sedentary lifestyle and 13.7% were smokers. 86.3% patients received statin monotherapy, with simvastatin (37%) and atorvastatin (34%) being the most commonly prescribed. The most common statin potency was equivalent to simvastatin 20-40mg/day. More than half of all patients were considered high or very high CV risk, with hypertension, coronary heart disease (CHD) and diabetes being the most prevalent comorbidities. Only 62% and 49% of patients reached LDL-C and TC goals, respectively, with goal attainment rates decreasing as CV risk increased. Women (OR=1.95, 95% CI=1.53-1.73), patients with diabetes (OR=3.25, 95% CI=2.58-2.90), cerebrovascular disease (OR=2.38, 95% CI=1.76-2.04), or CHD (OR=2.12, 95% CI=1.67-1.88) were more likely to fail LDL-C goal attainment after adjusting for other patient characteristics. View this table: Conclusions: Despite use of LLD, a large portion of patients, particularly those at greater CV risk had persistent lipid abnormalities. There is still an important need to optimize therapy to further bridge the gap between guideline recommendations and current Chinese practice.