Abstract
BackgroundAtherogenic dyslipidemia is associated with poor cardiovascular outcomes, yet markers of this condition are often ignored in clinical practice. Here, we address a clear evidence gap by assessing the prevalence and treatment of two markers of atherogenic dyslipidemia: elevated triglyceride levels and low levels of high-density lipoprotein cholesterol.MethodsThis cross-sectional observational study assessed the prevalence of two atherogenic dyslipidemia markers, high triglyceride levels and low high-density lipoprotein cholesterol levels, in the study population from the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA; N = 7641; of whom 51.6% were female and 95.6% were White/Caucasian). The EURIKA population included European patients, aged at least 50 years with at least one cardiovascular risk factor but no history of cardiovascular disease.ResultsOver 20% of patients from the EURIKA population have either triglyceride or high-density lipoprotein cholesterol levels characteristic of atherogenic dyslipidemia. Furthermore, the proportions of patients with one of these markers were higher in subpopulations with type 2 diabetes mellitus or those already calculated to be at high risk of cardiovascular disease. Approximately 55% of the EURIKA population who have markers of atherogenic dyslipidemia are not receiving lipid-lowering therapy.ConclusionsA considerable proportion of patients with at least one major cardiovascular risk factor in the primary cardiovascular disease prevention setting have markers of atherogenic dyslipidemia. The majority of these patients are not receiving optimal treatment, as specified in international guidelines, and thus their risk of developing cardiovascular disease is possibly underestimated.Trial registrationThe present study is registered with ClinicalTrials.gov (ID: NCT00882336).
Highlights
Atherogenic dyslipidemia is associated with poor cardiovascular outcomes, yet markers of this condition are often ignored in clinical practice
TG and C-reactive protein (CRP) levels are not taken into account in global cardiovascular risk calculators, such as the Systematic Coronary Risk Evaluation (SCORE) algorithm [13] and the risk calculator developed alongside the American College of Cardiology/American Heart Association (ACC/ AHA) 2013 guidelines [14]
There were higher proportions of patients classified as obese (BMI ≥ 30 kg/m2) in the subpopulations with high TG levels, low high-density lipoprotein cholesterol (HDL-C) levels, or both than in the overall population
Summary
Atherogenic dyslipidemia is associated with poor cardiovascular outcomes, yet markers of this condition are often ignored in clinical practice. We address a clear evidence gap by assessing the prevalence and treatment of two markers of atherogenic dyslipidemia: elevated triglyceride levels and low levels of highdensity lipoprotein cholesterol. We use data from the European Study on Cardiovascular Risk Prevention and Management in Usual Daily Practice (EURIKA, ClinicalTrials.gov identifier: NCT00882336), a cross-sectional observational study including data on patients from 12 European countries with at least one traditional CVD risk factor but no history of cardiovascular events [11, 12], to assess the prevalence and treatment of two markers of atherogenic dyslipidemia: elevated TG levels and low HDL-C levels. The impact of CRP and markers of atherogenic dyslipidemia on CVD risk is often underestimated in clinical practice, with a lack of evidence for the prevalence and treatment of the latter. TG and CRP levels are not taken into account in global cardiovascular risk calculators, such as the Systematic Coronary Risk Evaluation (SCORE) algorithm [13] and the risk calculator developed alongside the American College of Cardiology/American Heart Association (ACC/ AHA) 2013 guidelines [14]
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