Low-density lipoprotein cholesterol target attainment in patients with stable or acute coronary heart disease in the Asia-Pacific region: results from the Dyslipidemia International Study II

Kian Keong Poh, Baishali Ambegaonkar, Carl A. Baxter, Philippe Brudi, Wacin Buddhari, Fu Tien Chiang, Martin Horack, Yangsoo Jang, Brett Johnson, Dominik Lautsch, J. P.S. Sawhney, Ami Vyas, Bryan P. Yan, Anselm K. Gitt

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Abstract

Background: As mortality due to cardiovascular disease increases throughout the world, accurate data on risk factors such as hyperlipidemia are required. This is lacking in the Asia-Pacific region. Design: The observational Dyslipidemia International Study (DYSIS) II was established to quantify the extent of hyperlipidemia in adults with acute and stable coronary heart disease globally. Methods: Patients with stable coronary heart disease or hospitalised with an acute coronary syndrome were enrolled across nine Asia-Pacific countries from July 2013 to October 2014. Lipid-lowering therapy and low-density lipoprotein cholesterol target attainment (<70 mg/dL) were assessed. The acute coronary syndrome cohort was followed up 4 months post-discharge. Results: Of the 4592 patients enrolled, 2794 had stable coronary heart disease and 1798 were admitted with an acute coronary syndrome. In the coronary heart disease cohort, the mean low-density lipoprotein cholesterol level was 86.9 mg/dL, with 91.7% using lipid-lowering therapy and 31% achieving low-density lipoprotein cholesterol of less than 70 mg/dL. In the acute coronary syndrome cohort at admission, the corresponding values were 103.2 mg/dL, 63.4% and 23.0%, respectively. Target attainment was significantly higher in lipid-lowering therapy-treated than non-treated patients in each cohort (32.6% vs. 12.9% and 31.1% vs. 9.0%, respectively). Mean atorvastatin-equivalent dosages were low (20 ± 15 and 22 ± 18 mg/day, respectively), with little use of non-statin adjuvants (13.0% and 6.8%, respectively). Low-density lipoprotein cholesterol target attainment had improved by follow-up for the acute coronary syndrome patients, but remained low (41.7%). Conclusions: Many patients in Asia at very high risk of recurrent cardiovascular events had a low-density lipoprotein cholesterol level above the recommended target. Although lipid-lowering therapy was common, it was not used to its full potential.

Original languageEnglish
Pages (from-to)1950-1963
Number of pages14
JournalEuropean Journal of Preventive Cardiology
Volume25
Issue number18
DOIs
Publication statusPublished - 2018 Dec 1

All Science Journal Classification (ASJC) codes

  • Epidemiology
  • Cardiology and Cardiovascular Medicine

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    Poh, K. K., Ambegaonkar, B., Baxter, C. A., Brudi, P., Buddhari, W., Chiang, F. T., Horack, M., Jang, Y., Johnson, B., Lautsch, D., Sawhney, J. P. S., Vyas, A., Yan, B. P., & Gitt, A. K. (2018). Low-density lipoprotein cholesterol target attainment in patients with stable or acute coronary heart disease in the Asia-Pacific region: results from the Dyslipidemia International Study II. European Journal of Preventive Cardiology, 25(18), 1950-1963. https://doi.org/10.1177/2047487318798927