Contemporary data on low-density lipoprotein cholesterol target value attainment and distance to target in a cohort of 57,885 statin-treated patients by country and region across the world

Data presented here refer to 57,885 patients on lipid-lowering statin therapy from the Dyslipidaemia International Study (DYSIS) registry. Subjects were divided into 3 discrete subsets: those at very high-risk, high-risk, and non-high-risk for cardiovascular events, with assigned low density lipoprotein cholesterol (LDL-C) targets of 70 mg/dl, 100 mg/dl and 115 mg/dl, respectively. Overall, the highest proportion of patients meeting their LDL-C target was seen in the UAE and Kuwait (49.5%), while the lowest was seen in Germany (14.3%). The smallest median distance to target was documented in Canada (18.8 mg/dl), and the largest in the Baltics (42.1 mg/dl). Interpretation and discussion of this data can be found in the manuscript entitled “Low-density lipoprotein cholesterol in a global cohort of 57,885 statin-treated patients” (Gitt et al., 2016) [1]

Low-density lipoprotein cholesterol in a global cohort of 57,885 statin-treated patients

There is an inconsistency between international guidelines on lipid-lowering treatment regarding whether to pursue LDL-C treatment targets or to focus on the intensity of treatment. While either approach is attractive, there is no recent global data on actual LDL-C values, treatment targets attained, and the intensity of treatment in statin-treated patients. We aimed to determine and compare the extent of treatment target attainment globally using standardized data collection. Analyses were based on the Dyslipidemia International Study (DYSIS), a cross-sectional study documenting statin-treated outpatients throughout 30 countries worldwide (across Europe, the Middle East, Canada, Africa, and Asia). Patients were classified as being at very high, high, or non-high cardiovascular risk based on the 2011 European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guidelines. Data were available for a total of 57,885 patients with a median LDL-C value of 98.2 mg/dl (IQR: 76.6, 125.7 mg/dl). Overall, only 26.8% of patients were documented to have attained their risk-based target LDL-C level. Of the 76% of patients who were classified as being at very high risk, only 21.7% attained their LDL-C goal. Globally, the median distance to target was 33.0 mg/dl, ranging from 18.8 to 42.1 mg/dl across countries. We calculated that a further LDL-C reduction of just 10 mg/dl would result in an 11% increase in the proportion of very-high-risk and high-risk patients attaining their target level (9% for non-high risk patients). In spite of statin therapy, LDL-C values were high, with a substantial distance to target that was even more pronounced in (very) high risk patients. These results call for the optimization of existing treatment strategies and a collaborative effort to improve the impact of treatment guidance on clinical practic

The future of clinical trials in secondary prevention after acute coronary syndromes

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