Shuiping Zhao1, Yongjun Wang2, Yiming Mu3, Bilian Yu1, Ping Ye4, Xiaowei Yan5, Zhanquan Li6, Yidong Wei7, Baishaili M Ambegaonakr8, Dayi Hu9. 1. Department of Cardiology, Second Xiangya Hospital, Central South University, No.139, People Street (M.), Changsha 410011, China. 2. Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, No. 6, Tiantan Xi Li, Dongcheng District, Beijing 100050, China. 3. Department of Endocrinology, Chinese PLA General Hospital, No.28, Fuxing Rd, Haidian District, Beijing 100853, China. 4. Department of Geriatric Cardiology, Chinese PLA General Hospital, No.28, Fuxing Rd, Haidian District, Beijing 100853, China. 5. Department of Cardiology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, No.1, Shuai Fu Yuan, Dongcheng District, Beijing 100730, China. 6. Department of Cardiology, The People's Hospital of Liaoning Province, No. 33, Wen Yi Rd., Shenhe District, Shenyang 110016, China. 7. Department of Cardiology, Tenth People's Hospital of Tongji University, No. 301, Yanchang Rd. (M), Shanghai 200072, China. 8. Merck & Co., Inc., Whitehouse Station, NJ, USA. 9. Department of Cardiology, Peking University People's Hospital, No.11, Xi Zhi Men Nan Da Jie, Xicheng District, Beijing 100044, China. Electronic address: dayi.hu@medmail.com.cn.
Abstract
BACKGROUND: Despite clear guideline recommendations, there is a paucity of data regarding the prevalence and type of persistent lipid profile abnormalities in patients on stable lipid-lowering therapy in China. METHODS: This cross-sectional trial included 25,697 patients treated with lipid-lowering agents from 122 centres between April 2012 and October 2012; all underwent clinical examination and had their latest fasting lipid profiles while on lipid-lowering therapy recorded. Logistic regression was performed to assess predictors for lipid abnormalities classified according to current Chinese guidelines. FINDINGS: Overall, 29.1% of patients had no lipid abnormalities, and 38.5% of patients did not achieve the therapeutic goal for low-density lipoprotein cholesterol (LDL-C), either as a single lipid anomaly or associated with low high-density lipoprotein cholesterol (HDL-C), elevated triglycerides, or both. Subjects with low risk were more likely than those with very high and high risk to be at target LDL-C levels. Furthermore, 10.4% of very high-risk patients and 11.1% of high-risk patients who attained the LDL-C goal failed to attain non-HDL-C goals. Diabetes was shown to be a strong predictor of failure in attaining non-HDL-C and both goals (OR 3.03; 3.22, 95% CI 2.58-3.55; 2.73-3.79, respectively). CONCLUSION: Although great improvements have been made over the past decade, the large majority of very high-risk and high-risk patients treated with lipid-lowing agents still had one or more manifestations of dyslipidaemia. Further clinical evidence is needed to clarify whether adding other lipid-lowering agents to a statin will be associated with additional cardiovascular risk reduction.
BACKGROUND: Despite clear guideline recommendations, there is a paucity of data regarding the prevalence and type of persistent lipid profile abnormalities in patients on stable lipid-lowering therapy in China. METHODS: This cross-sectional trial included 25,697 patients treated with lipid-lowering agents from 122 centres between April 2012 and October 2012; all underwent clinical examination and had their latest fasting lipid profiles while on lipid-lowering therapy recorded. Logistic regression was performed to assess predictors for lipid abnormalities classified according to current Chinese guidelines. FINDINGS: Overall, 29.1% of patients had no lipid abnormalities, and 38.5% of patients did not achieve the therapeutic goal for low-density lipoprotein cholesterol (LDL-C), either as a single lipidanomaly or associated with low high-density lipoprotein cholesterol (HDL-C), elevated triglycerides, or both. Subjects with low risk were more likely than those with very high and high risk to be at target LDL-C levels. Furthermore, 10.4% of very high-risk patients and 11.1% of high-risk patients who attained the LDL-C goal failed to attain non-HDL-C goals. Diabetes was shown to be a strong predictor of failure in attaining non-HDL-C and both goals (OR 3.03; 3.22, 95% CI 2.58-3.55; 2.73-3.79, respectively). CONCLUSION: Although great improvements have been made over the past decade, the large majority of very high-risk and high-risk patients treated with lipid-lowing agents still had one or more manifestations of dyslipidaemia. Further clinical evidence is needed to clarify whether adding other lipid-lowering agents to a statin will be associated with additional cardiovascular risk reduction.