Uncontrolled hyperlipidemia in Chinese patients who experienced acute coronary syndrome: an observational study

Abstract

Jie Jiang,1 Yu-Jie Zhou,2 Jian-Jun Li,3 Jun-Bo Ge,4 Ying-Qing Feng,5 Yong Huo1 On behalf of ASAP Study Investigators 1Department of Cardiology, Peking University First Hospital, Xicheng District, Beijing 100034, China; 2Department of Cardiology, Beijing Anzhen Hospital, Chaoyang District, Beijing 100029, China; 3Department of Cardiology, Fuwai Hospital, Xicheng District, Beijing 100037, China; 4Department of Cardiology, Fudan University Zhongshan Hospital, Xuhui District, Shanghai 200032, China; 5Department of Cardiology, Guangdong General Hospital, Yuexiu District, Guangzhou, Guangdong Province 510080, China Objective: Despite current standard of care, the overall lipid goal attainment rate for hyperlipidemia patients, especially those who have experienced acute coronary syndrome (ACS), is suboptimal, which predisposes them to a higher residual risk of atherothrombotic events. This study aimed to describe characteristics of Chinese patients who recently experienced an ACS event and were on lipid-lowering treatment, yet failing to reach targeted goal. Methods: A multicenter, cross-sectional study was conducted to recruit 2,034 Chinese patients who experienced an ACS (ST segment elevation myocardial infarction [STEMI], non-STEMI, or unstable angina) event within the past 4–40 weeks and were on statin treatment (>2 weeks) from March 2015 to December 2016. All eligible patients underwent a fasting lipid test after enrollment and data on medical history were collected. Results: The mean age of 1,994 eligible patients was 61.0±9.84 years. Among them, 1,493 (74.9%) patients received intensive statin therapy (defined as atorvastatin 40 or 80 mg, or rosuvastatin 20 mg per protocol) and 499 (25.0%) patients were on maximum tolerated dose statin. Of the 1,994 eligible subjects, 1,273 (63.8%) patients did not achieve the lipid goal at the time of enrollment. Among the not-at-goal patients, 910 (71.5%) received intensive statin therapy; the majority (73.4%) of them were male; the mean age was 61.2±10.1 years old; 699 (54.9%) patients had a history of hypertension; 25.3% had diabetes mellitus; and 29.5% were current smokers. The mean low-density lipoprotein-cholesterol (LDL-C), non-high-density lipoprotein-cholesterol (non-HDL-C), and ApoB levels at enrollment of this group of patients were 2.460±0.7139 mmol/L, 3.094±0.8861 mmol/L, and 0.840±0.3015 g/L, respectively. Conclusion: The study result demonstrates that overall more than half of the patients who recently (4–40 weeks) experienced ACS who were treated did not reach the guideline-recommended LDL-C and non-HDL-C goal. These results highlight the potential necessity for a new drug beyond statins to further reduce disease burden in the future. Keywords: acute coronary syndrome, intensive statin treatment, lipid goal attainment, lipid-lowering treatment

Keywords

• acute coronary syndrome
• intensive statin treatment
• lipid goal attainment
• lipid lowering treatment