Aims: Atherosclerosis is the leading cause of cardiovascular morbidity and mortality in Italy. One of its principal risk factors is dyslipidemia. The aim of our study was to determine the accuracy of antihypercholesterolemic treatment in high-risk patients [low-density lipoprotein (LDL) > 100 mg/dl] discharged from hospital.
Methods: Among all the patients aged 40-70 years hospitalized at S. Orsola-Malpighi Hospital, Bologna, during 2008, we selected patients who had established arterial disease (coronary artery disease, cerebrovascular disease, peripheral arterial disease) or diabetes; excluding patients with creatine kinase or transaminase alterations, renal function impairment, diagnosis of hypercholesterolemia alone or incomplete lipid profile; the final population included 999 participants. Total cholesterol, high-density lipoprotein cholesterol and triglycerides were measured on blood samples. LDL-cholesterol was obtained by the Friedwald formula. Statin use was evaluated through medical records, comparing admission and discharge. The χ(2)-test was used to compare the percentage of patients on lipid-lowering treatment at admission and discharge.
Results: Considering all 462 individuals with LDL-cholesterol levels more than 100 mg/dl, statin treatment increased from 25.5% at admission to 61.7% at discharge; however, more than 38% of patients who deserved a pharmacological therapy were not treated. In addition, we observed an improvement in lipid-lowering therapy only in 23 patients with LDL-cholesterol levels more than 100 mg/dl already under statin treatment.
Conclusion: Our data show that dyslipidemia is generally undertreated in high-risk patients, despite the fact that hospitalization brings them in contact with specialized physicians.