Dyslipidemia and Rate of Under-Target
Low-Density Lipoprotein-Cholesterol in Patients with Coronary Artery Disease in Korea
Authors
Sang-Hak Lee ; Woo-Hyuk Song ; Myung Ho Jeong ; Seung-Ho Hur ; Dong Woon Jeon ; Wonju Jeung ; Anselm K Git ; Martin Horack ; Ami Vyas ; Dominik Lautsch ; Baishali Ambegaonkar ; Philippe Brudi ; Yangsoo Jang
Citation
Journal of Lipid and Atherosclerosis, Vol.8(2) : 242-251, 2019
Objective: The aim of this study was to evaluate under target rates of low-density lipoproteincholesterol
(LDL-C) in Korean patients with stable coronary artery disease (CAD) or an acute
coronary syndrome (ACS) in real world practice.
Methods: Dyslipidemia International Study II was an international observational study of
patients with stable CAD or an ACS. Lipid profiles and use of lipid-lowering therapy (LLT) were
documented at enrollment, and for the ACS cohort, 4 months follow-up was recommended.
Rates of under target LDL-C as per European guidelines, were evaluated, and multivariate
regression was performed to identify predictive factors of patients presenting under the target.
Results: A total of 808 patients were enrolled in Korea, 500 with stable CAD and 308 with
ACS. Of these, 90.6% and 52.6% were being treated with LLT, respectively. In the stable CAD
group, 40.0% were under target LDL-C, while in ACS group, the rate was 23.7%. A higher
statin dose was independently associated with under target LDL-C in both groups (OR, 1.03;
p=0.046 [stable CAD] and OR, 1.05; p=0.01 [ACS]). The mean statin dosage (atorvastatin
equivalent) was 17 mg/day. In the 79 ACS patients who underwent the follow-up examination,
the LDL-C under target rate rose to 59.5%.
Conclusion: Only a minority of patients with stable CAD or ACS were under their target
LDL-C level at enrollment. The statin dose was not sufficient in the majority of patients.
These results indicate a considerable LLT gap in Korean patients with established CAD.