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

Abstract

BACKGROUND:

Dyslipidemia 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).

HYPOTHESIS:

Compliance with treatment guideline recommendations improves the LDL-C goal attainment rate in post-ACS patients.

METHODS:

This 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.

RESULTS:

The 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.

CONCLUSIONS:

This 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.

• Authors: Yanjun Gong, Xuan Li, Xiang Ma, Hongwei Yu, Ying Li, Jiyan Chen, Guochun Zhang, Bin Wang, Xiaoyong Qi, Haiyan Meng, Xiaofeng Wang, Jianjun Mu, Xitian Hu, Jingping Wang, Shaowen Liu, Gang Liu, Zhenyu Yang, Yujie Zhou, Xiangqing Kong, Yuhu Yan, Changqian Wang, Jian' An Wang, Lijun Wang, Guosheng Fu, Lin Wei, Daoquan Peng, Shuyang Zhang, Ruogu Li, Anhua Mao, Rui Bian, Wenmin Tang, Yuqin Ran, Jie Jiang, Yong Huo
• Journal: Clinical cardiology (Clin Cardiol) Vol. 44 Issue 11 Pg. 1575-1585 (Nov 2021) ISSN: 1932-8737 [Electronic] United States
• PMID: 34651329 (Publication Type: Journal Article, Multicenter Study, Observational Study)
• Copyright: © 2021 The Authors. Clinical Cardiology published by Wiley Periodicals LLC.

Chemical References

• Hydroxymethylglutaryl-CoA Reductase Inhibitors
• Lipids

Topics

• Acute Coronary Syndrome (diagnosis, drug therapy)
• China (epidemiology)
• Dyslipidemias (diagnosis, drug therapy, epidemiology)
• Goals
• Humans
• Hydroxymethylglutaryl-CoA Reductase Inhibitors (therapeutic use)
• Lipids
• Male
• Treatment Outcome