1. Achievement of low-density lipoprotein cholesterol goals in 18 countries outside Western Europe: The International ChoLesterol management Practice Study (ICLPS).
- Author
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Danchin N, Almahmeed W, Al-Rasadi K, Azuri J, Berrah A, Cuneo CA, Karpov Y, Kaul U, Kayıkçıoğlu M, Mitchenko O, Ruiz AJ, Aguilar Salinas CA, Santos RD, Mercier F, and Blom D
- Subjects
- Adult, Aged, Anticholesteremic Agents adverse effects, Biomarkers blood, Cardiovascular Diseases blood, Cardiovascular Diseases diagnosis, Cardiovascular Diseases epidemiology, Comorbidity, Cross-Sectional Studies, Down-Regulation, Dyslipidemias blood, Dyslipidemias diagnosis, Dyslipidemias epidemiology, Female, Guideline Adherence, Humans, Male, Middle Aged, Practice Guidelines as Topic, Practice Patterns, Physicians', Risk Factors, Sex Factors, Smoking adverse effects, Smoking epidemiology, Time Factors, Treatment Outcome, Anticholesteremic Agents therapeutic use, Cardiovascular Diseases prevention & control, Cholesterol, LDL blood, Dyslipidemias drug therapy
- Abstract
Background Little is known about the achievement of low density lipoprotein cholesterol (LDL-C) targets in patients at cardiovascular risk receiving stable lipid-lowering therapy (LLT) in countries outside Western Europe. Methods This cross-sectional observational study was conducted in 452 centres (August 2015-August 2016) in 18 countries in Eastern Europe, Asia, Africa, the Middle East and Latin America. Patients ( n = 9049) treated for ≥3 months with any LLT and in whom an LDL-C measurement on stable LLT was available within the previous 12 months were included. Results The mean±SD age was 60.2 ± 11.7 years, 55.0% of patients were men and the mean ± SD LDL-C value on LLT was 2.6 ± 1.3 mmol/L (101.0 ± 49.2 mg/dL). At enrolment, 97.9% of patients were receiving a statin (25.3% on high intensity treatment). Only 32.1% of the very high risk patients versus 51.9% of the high risk and 55.7% of the moderate risk patients achieved their LDL-C goals. On multivariable analysis, factors independently associated with not achieving LDL-C goals were no (versus lower dose) statin therapy, a higher (versus lower) dose of statin, statin intolerance, overweight and obesity, female sex, neurocognitive disorders, level of cardiovascular risk, LDL-C value unknown at diagnosis, high blood pressure and current smoking. Diabetes was associated with a lower risk of not achieving LDL-C goals. Conclusions These observational data suggest that the achievement of LDL-C goals is suboptimal in selected countries outside Western Europe. Efforts are needed to improve the management of patients using combination therapy and/or more intensive LLTs.
- Published
- 2018
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