Frequency and predictors of cholesterol target attainment in patients with stable coronary heart disease in Belgium: results from the Dyslipidemia International Study II (DYSIS II CHD)

Acta Clin Belg. 2019 Dec;74(6):399-404. doi: 10.1080/17843286.2018.1539203. Epub 2018 Oct 25.

Abstract

Objectives: To document the frequency and predictors of low-density lipoprotein cholesterol (LDL-C) target value attainment among patients with coronary heart disease (CHD) in Belgium. Methods: The second Dyslipidemia International Study (DYSIS II) was an observational study of the prevalence of dyslipidemias and lipid target value attainment. Patients in this analysis were aged ≥ 18, had documented CHD, and had a full lipid profile. Use of lipid-lowering therapy (LLT), lipid profile, and LDL-C target value attainment (< 70 mg/dL) were assessed cross-sectionally at the enrollment visit. The distribution of LLTs was assessed among treated patients. Multivariate logistic regression was used to identify variables predictive of LDL-C target value attainment in treated patients. Results: We identified 409 patients with CHD in Belgium, 387 (94.6%) of whom were on LLT at the time of the lipid profile. Among treated patients, the rate of LDL-C target value attainment was 40.6%, and statin monotherapy was the most commonly used LLT (79.3%). Among users of statin monotherapy or combination therapy, simvastatin was the most commonly used treatment (41.6% of patients). Diabetes was associated with higher odds of LDL-C target value attainment (OR 2.29, 95% CI 1.33-3.93), and female gender was associated with lower odds (OR 0.48, 95% CI 0.24-0.97). Conclusion: Rates of LDL-C target value attainment are low in patients with CHD in Belgium. Intensifying statin therapy or combining it with non-statins is essential in Belgian patients for optimal LDL-C reduction.

Keywords: Belgium; LDL-cholesterol; cardiovascular disease; dyslipidemias; statins.

Publication types

  • Observational Study

MeSH terms

  • Aged
  • Belgium / epidemiology
  • Cholesterol, LDL / blood*
  • Comorbidity
  • Coronary Disease* / blood
  • Coronary Disease* / epidemiology
  • Coronary Disease* / therapy
  • Diabetes Mellitus / epidemiology
  • Dyslipidemias* / blood
  • Dyslipidemias* / drug therapy
  • Dyslipidemias* / epidemiology
  • Female
  • Health Services Misuse / prevention & control
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use*
  • Hypolipidemic Agents / therapeutic use
  • Male
  • Medication Therapy Management* / standards
  • Medication Therapy Management* / statistics & numerical data
  • Middle Aged
  • Sex Factors

Substances

  • Cholesterol, LDL
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Hypolipidemic Agents