BACKGROUND: Statins are proven to reduce cardiovascular risk; however, substantial risk remains in patients on statin therapy. Persisting dyslipidaemia is likely to play a contributory role. AIM: To assess the prevalence of persisting lipid abnormalities in patients treated with statins. METHODS: DYSIS was a cross-sectional study of 22,063 patients in Europe and Canada. 900 Irish patients participated. All patients were ≥ 45 years and treated with statins for ≥ 3 months. Data were collected from the patients' records. ESC guidelines were used to classify risk and to define lipid levels. RESULTS: Mean age was 66.1 years with women representing 40.7%. 78.6% were high-risk patients; that is 53.9% with cardiovascular disease (CVD), 20.1% with diabetes and 15.9% with a SCORE risk ≥ 5%. Total cholesterol was not at goal in 34.4% of all patients. LDL-C was elevated in 30.8% of all patients and in 30% at high risk. Low HDL-C was found in 34.7% of high-risk patients compared to 16.9% of patients with an ESC score <5%. In diabetics without CVD, low HDL-C and elevated TGs were found in 46 and 44.3%, respectively. CONCLUSIONS: Despite statin therapy, a significant number of patients have persistent dyslipidaemia. While LDL-C targets are suboptimal in three out of ten patients, the prevalence of low HDL-C and high TGs in high-risk patients is greater than one in three. A more integrated approach to the treatment of patients with dyslipidaemia is warranted. Clinical trials are needed to assess the impact of therapies that raise HDL-C and lower elevated TGs.
BACKGROUND: Statins are proven to reduce cardiovascular risk; however, substantial risk remains in patients on statin therapy. Persisting dyslipidaemia is likely to play a contributory role. AIM: To assess the prevalence of persisting lipid abnormalities in patients treated with statins. METHODS: DYSIS was a cross-sectional study of 22,063 patients in Europe and Canada. 900 Irish patients participated. All patients were ≥ 45 years and treated with statins for ≥ 3 months. Data were collected from the patients' records. ESC guidelines were used to classify risk and to define lipid levels. RESULTS: Mean age was 66.1 years with women representing 40.7%. 78.6% were high-risk patients; that is 53.9% with cardiovascular disease (CVD), 20.1% with diabetes and 15.9% with a SCORE risk ≥ 5%. Total cholesterol was not at goal in 34.4% of all patients. LDL-C was elevated in 30.8% of all patients and in 30% at high risk. Low HDL-C was found in 34.7% of high-risk patients compared to 16.9% of patients with an ESC score <5%. In diabetics without CVD, low HDL-C and elevated TGs were found in 46 and 44.3%, respectively. CONCLUSIONS: Despite statin therapy, a significant number of patients have persistent dyslipidaemia. While LDL-C targets are suboptimal in three out of ten patients, the prevalence of low HDL-C and high TGs in high-risk patients is greater than one in three. A more integrated approach to the treatment of patients with dyslipidaemia is warranted. Clinical trials are needed to assess the impact of therapies that raise HDL-C and lower elevated TGs.
Authors: Scott M Grundy; James I Cleeman; C Noel Bairey Merz; H Bryan Brewer; Luther T Clark; Donald B Hunninghake; Richard C Pasternak; Sidney C Smith; Neil J Stone Journal: Circulation Date: 2004-07-13 Impact factor: 29.690
Authors: Kornelia Kotseva; David Wood; Guy De Backer; Dirk De Bacquer; Kalevi Pyörälä; Ulrich Keil Journal: Lancet Date: 2009-03-14 Impact factor: 79.321
Authors: Kornelia Kotseva; David Wood; Guy De Backer; Dirk De Bacquer; Kalevi Pyörälä; Ulrich Keil Journal: Eur J Cardiovasc Prev Rehabil Date: 2009-04
Authors: Ian Graham; Dan Atar; Knut Borch-Johnsen; Gudrun Boysen; Gunilla Burell; Renata Cifkova; Jean Dallongeville; Guy De Backer; Shah Ebrahim; Bjørn Gjelsvik; Christoph Herrmann-Lingen; Arno Hoes; Steve Humphries; Mike Knapton; Joep Perk; Silvia G Priori; Kalevi Pyorala; Zeljko Reiner; Luis Ruilope; Susana Sans-Menendez; Wilma Scholte op Reimer; Peter Weissberg; David Wood; John Yarnell; Jose Luis Zamorano; Edmond Walma; Tony Fitzgerald; Marie Therese Cooney; Alexandra Dudina Journal: Eur Heart J Date: 2007-08-28 Impact factor: 29.983
Authors: David C Goff; Alain G Bertoni; Holly Kramer; Denise Bonds; Roger S Blumenthal; Michael Y Tsai; Bruce M Psaty Journal: Circulation Date: 2006-02-07 Impact factor: 29.690
Authors: Sami T Azar; Hadi Abu Hantash; Selim Jambart; Mohamed M El-Zaheri; Rachoin Rachoin; Amal Chalfoun; Layla Lahoud; Osama Okkeh; Peter Bramlage; Philippe Brudi; Baishali M Ambegaonkar Journal: Vasc Health Risk Manag Date: 2014-05-07