Devroey D, Radermecker RP, Van der Schueren BJ, Torbeyns B, Jaken R. Prevalence of persistent lipid abnormalities in statin-treated patients: Belgian results of the Dyslipidemia International Study (DYSIS). WONCA 2013 World Conference, Prague, Czech Republic.
Eerste auteur: Devroey D
Jaar: 2013
Type: Congres
Abstract:
Background - A substantial number of cardiovascular events are not prevented by statin therapy, which is still regarded as the first-line therapy for hyperlipidemia. Insights into the prevalence of lipid abnormalities of statin treated patients in Belgium is lacking and may shed light on an unmet medical need for optimal use of current lipid-lowering therapies.
Aim - This study aims to assess the prevalence and types of persistent lipid abnormalities in patients receiving statin therapy in a real-life primary care setting in Belgium.
Methods - This cross-sectional cohort study was designed to estimate the prevalence of all lipid abnormalities in statin-treated patients in Belgium. Total cholesterol, low density lipoprotein-cholesterol (LDL-C), high density lipoprotein-cholesterol (HDL‑C), and triglycerides were recorded from the patients' medical record. Patient's total cardiovascular risk and corresponding lipid treatment goals were defined based on the recent European Society of Cardiology / European Atherosclerosis Society recommendations.
Results - Overall, 55.8% of the 953 statin-treated patients were not at goal for LDL-C. Low HDL-C (<40mg/dl in men, <50 mg/dl in women) and elevated triglycerides (>150 mg/dl) were seen in 16.4% and 29.3% of patients, respectively. Very high risk patients were more likely to have LDL-C not at goal (70.9% of them), while 60.0% of high-risk patients and 33.7% of moderate-risk patients were not at goal for LDL-C. Use of ezetimibe was strongly associated with meeting LDL-C goals (OR 18.2, p<0.0001).
Conclusion - In Belgium, lipid abnormalities remained highly prevalent despite statin treatment, with more than half of all patients not reaching their LDL-C treatment goal. This finding clearly indicates that more aggressive lipid lowering treatment is required in clinical daily practice to achieve the goals of the current guidelines. This might be achieved by up-titrating statins or adding other lipid lowering drugs such as ezetimibe.