OBJECTIVES: According to various national and international guidelines, the target LDL-C level is <100 mg/dl for patients with established coronary heart disease (CHD) or CHD risk equivalent (CE). We aimed to investigate aspects of the lipid-lowering management of patients at high cardiovascular risk in-hospital care and the achievement of target values. METHODS: In the internet-based 2L registry in Germany (2005-2006), cardiologists in 42 hospitals documented at a single visit 3,131 consecutive patients with known CHD, and/or diabetes mellitus, peripheral arterial disease, or a 10-year CHD risk >20% (summarized as CE), who were on chronic statin treatment. They received instructions on the guidelines and instant feedback on the effect of their treatment decisions (educational study component). RESULTS: The three groups comprised 1,458 patients with CHD + CE (46.6%; median LDL-C 107 mg/dl), 1,104 patients with CHD only (35.3%; median LDL-C 104 mg/dl), and 569 with CE only (18.2%; median LDL-C 111 mg/dl). At admission, LDL-C levels <100 mg/dl were observed in 43.1, 44.8 and 37.9% of patients in the three groups, respectively. Statin doses at admission were usually in the low to intermediate range (e.g., simvastatin 10-20 mg/day). Cardiologists switched to another statin in 14.6%, increased the dose of statins (if same drug) in 22.9% (mean increase from 26.8 mg/day at baseline to 31.6 mg/day) and/or added a cholesterol absorption inhibitor (CAI) in 11.6%. The cardiologists' intervention improved estimated LDL-C levels (using a lipid calculator); however, the 100 mg/dl LDL-C target was only reached in 49.0, 48.5, and 42.9%. CONCLUSIONS: When compared with earlier studies in the outpatient setting, the treatment to target for LDL-C of high-risk CHD patients has improved, but is not satisfactory.
OBJECTIVES: According to various national and international guidelines, the target LDL-C level is <100 mg/dl for patients with established coronary heart disease (CHD) or CHD risk equivalent (CE). We aimed to investigate aspects of the lipid-lowering management of patients at high cardiovascular risk in-hospital care and the achievement of target values. METHODS: In the internet-based 2L registry in Germany (2005-2006), cardiologists in 42 hospitals documented at a single visit 3,131 consecutive patients with known CHD, and/or diabetes mellitus, peripheral arterial disease, or a 10-year CHD risk >20% (summarized as CE), who were on chronic statin treatment. They received instructions on the guidelines and instant feedback on the effect of their treatment decisions (educational study component). RESULTS: The three groups comprised 1,458 patients with CHD + CE (46.6%; median LDL-C 107 mg/dl), 1,104 patients with CHD only (35.3%; median LDL-C 104 mg/dl), and 569 with CE only (18.2%; median LDL-C 111 mg/dl). At admission, LDL-C levels <100 mg/dl were observed in 43.1, 44.8 and 37.9% of patients in the three groups, respectively. Statin doses at admission were usually in the low to intermediate range (e.g., simvastatin 10-20 mg/day). Cardiologists switched to another statin in 14.6%, increased the dose of statins (if same drug) in 22.9% (mean increase from 26.8 mg/day at baseline to 31.6 mg/day) and/or added a cholesterol absorption inhibitor (CAI) in 11.6%. The cardiologists' intervention improved estimated LDL-C levels (using a lipid calculator); however, the 100 mg/dl LDL-C target was only reached in 49.0, 48.5, and 42.9%. CONCLUSIONS: When compared with earlier studies in the outpatient setting, the treatment to target for LDL-C of high-risk CHD patients has improved, but is not satisfactory.
Authors: B M Psaty; T D Koepsell; D Lin; N S Weiss; D S Siscovick; F R Rosendaal; M Pahor; C D Furberg Journal: J Am Geriatr Soc Date: 1999-06 Impact factor: 5.562
Authors: Robert J Valuck; Setareh A Williams; Marilyn MacArthur; Joseph J Saseen; Kavita V Nair; Marianne McCollum; Joe E Ensor Journal: Clin Ther Date: 2003-11 Impact factor: 3.393
Authors: Sidney C Smith; Jerilyn Allen; Steven N Blair; Robert O Bonow; Lawrence M Brass; Gregg C Fonarow; Scott M Grundy; Loren Hiratzka; Daniel Jones; Harlan M Krumholz; Lori Mosca; Richard C Pasternak; Thomas Pearson; Marc A Pfeffer; Kathryn A Taubert Journal: Circulation Date: 2006-05-16 Impact factor: 29.690
Authors: Stefan Lange; Hans Joachim Trampisch; Roman Haberl; Harald Darius; David Pittrow; Alexander Schuster; Berndt von Stritzky; Gerhart Tepohl; Jens Rainer Allenberg; Curt Diehm Journal: Atherosclerosis Date: 2005-02 Impact factor: 5.162
Authors: H Völler; R Reibis; D Pittrow; C Jannowitz; K Wegscheider; B Karmann; K Bestehorn Journal: Curr Med Res Opin Date: 2009-04 Impact factor: 2.580
Authors: Laney K Jones; Stephanie Tilberry; Christina Gregor; Lauren H Yaeger; Yirui Hu; Amy C Sturm; Terry L Seaton; Thomas J Waltz; Alanna K Rahm; Anne Goldberg; Ross C Brownson; Samuel S Gidding; Marc S Williams; Michael R Gionfriddo Journal: Implement Sci Date: 2021-04-13 Impact factor: 7.327