[Treatment with statins in general medicine: dosage and effectiveness. Results of the observational study STATIMED].
Using a retrospective study in general medicine, we observed the rates of achieving targets for LDL-cholesterol as recommended by the French Agency for the Safety of Health care Products (AFSSAPS) in 2000, according to the types of statin prescribed and the dosages used. Out of 64 961 individuals treated with a statin between 31 July 2001 and 1 August 2002, we identified 22 065 patients treated with monotherapy, having had an LDL-cholesterol level performed at least 6 weeks after starting treatment or after changing statin or dosage, and no longer than 6 months before the start of our study in the other cases. In primary prevention, 81.9% of patients attained their objectives. The success rates became less impressive with increasing levels of cardiovascular risk: 95.6%, 86.9%, 72.0% and 56.3% for 0, 1, 2 and 3 or more risk factors respectively (p < 0.0001). For secondary prevention, the targets were only met for 62.8% of patients. In total, only 77.8% of the entire sample met their targets. For each type of statin, higher doses were used for patients with higher cardiovascular risk, but the percentage of patients reaching their LDL-cholesterol targets diminished. In conclusion, under the current conditions of managing lipid risk, the LDL-cholesterol targets are not sufficiently met. Extrapolating from the data obtained in this study, about 300 000 patients in France require better management than recommended in the 2000 AFSSAPS guidelines.
Amouyel
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P
INSERM U508, Institut Pasteur de Lille, 1 rue Calmette, 59019 Lille. philippe.amouyel@pasteur-lille.fr
Lamarque
H
H
Gayet
J L
JL
D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood / Q000517:prevention & control*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood / Q000187:drug effects; D003327:Coronary Disease / Q000517:prevention & control*; D005194:Family Practice; D005260:Female; D005602:France; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000097:blood / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D011322:Primary Prevention; D012189:Retrospective Studies; D012307:Risk Factors
D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors