Correlates of LDL-cholesterol goal attainment in patients under lipid lowering therapy

Abstract 

Background

LDL-cholesterol therapeutic objectives attainment under lipid lowering therapy remains inadequate. The correlates of LDL-cholesterol therapeutic objective attainment have not been thoroughly explored in an observational setting.

Methods

Patients under lipid lowering therapy and managed by general practitioners were included. LDL-cholesterol therapeutic objective was defined according to the number of cardiovascular risk factors associated with dyslipidemia (AFSSAPS-2005 guidelines).

Results

Most of the 2727 patients (mean age: 64.7±11.0) received a statin (70.0%) or a fibrate (24.3%) in monotherapy. 58.5% of patients at high cardiovascular risk did not reach therapeutic objective. Compared to simvastatin, patients receiving fibrates were less likely to be at therapeutic objective (OR=0.38, 95% CI=[0.26–0.54]). So were patients receiving fluvastatin (OR=0.41, IC95%=[0.26–0.64]) or pravastatin (OR=0.49, IC95%=[0.35–0.70]) at the dosages used by GPs.

No significant difference appeared with atorvastatin (OR=0.99, 95% CI=[0.71–1.39]) or rosuvastatin (OR=1.25, CI95%=[0.77–2.02]). Patients with LDL-cholesterol levels<0.7g/L tended to be prescribed high doses of lipid lowering therapy.

Conclusions

In real conditions of lipid lowering therapy use, LDL-cholesterol therapeutic objective attainment was inadequate in high-risk patients, and TO differences were observed between drugs at prescribed doses.

Keywords: Dyslipidemia, LDL-cholesterol, Lipid lowering therapy, Statin, Cardiovascular risk