Low-density lipoprotein cholesterol in patients treated with atypical antipsychotics: missed targets and lost opportunities.
BACKGROUND
The treatment of psychotic disorders with second-generation antipsychotics (SGAs) has been linked to an increased risk of coronary heart disease (CHD). Lowering low-density lipoprotein-cholesterol (LDL-C) to individualized targets of 100, 130 or 160 mg/dl reduces the risk of CHD. We determined the prevalence of above-target LDL-C and its management during psychiatric hospitalization.


METHODS
364 hospitalized adults receiving SGAs underwent LDL-C target assessments. Records of patients with above-target LDL-C were searched for dietary or pharmacologic treatments and referrals for medical consultation.


RESULTS
Above-target LDL-C levels were present in 100 (27.5%) patients and were associated with higher total cholesterol, lower high-density lipoprotein cholesterol, older age, higher systolic blood pressure, smoking and male gender (r(2): 0.53; p<0.0001). Only 32.0% of these patients received appropriate interventions during hospital stays of 27.6+/-23.3 days.


CONCLUSIONS
A substantial number of SGA-treated patients have above-target LDL-C, but do not receive interventions to reduce the risk of CHD.
Correll
Christoph U
CU
The Zucker Hillside Hospital, North Shore-Long Island Jewish Health System, Glen Oaks, NY, USA.
Harris
Jean L
JL
Pantaleon Moya
Rudy A
RA
Frederickson
Anne M
AM
Kane
John M
JM
Manu
Peter
P
D000328:Adult; D000368:Aged; D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood*; D003327:Coronary Disease / Q000139:chemically induced / Q000453:epidemiology; D003710:Demography; D050171:Dyslipidemias / Q000188:drug therapy* / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011618:Psychotic Disorders / Q000188:drug therapy* / Q000453:epidemiology* / Q000523:psychology; D012307:Risk Factors
D014150:Antipsychotic Agents; D008076:Cholesterol, HDL; D008078:Cholesterol, LDL