Reaching target lipid levels in patients at high risk of cardiovascular event: the experience of a Canadian tertiary care lipid clinic.
OBJECTIVE
To determine the proportion of high risk patients followed at a tertiary care lipid clinic who met recommended lipid targets and to identify predictors of reaching goal lipid levels.


METHODS
A retrospective cohort study of 502 high risk patients followed between 1983 and 2003. Clinical and demographic data and fasting lipid profiles were extracted from each patient's first two clinic visits as well as the most recent visit.


RESULTS
All patients in this study were at high risk of cardiovascular events due to dyslipidemia. At "Visit 1", only 55 (11.0%) of patients were at target TC/HDL-C < 4.0, and 97 (19.3%) of patients met target LDL-C < 2.5 mmol/l. At "Visit 3", 229 (45.8%) patients reached TC/HDL-C target, and 216 (43.2%) patients were at LDL-C target. The mean change in lipid values between Visit 1 and Visit 3 was significant (p = 0.0002) for LDL-C and (p < 0.0001) for TC/HDL-C. The use of statins, niacin, or salmon oil were all significantly associated with reaching TC/HDL-C target and LDL-C target, as well male gender, diabetes mellitus and peripheral vascular disease were also associated with reaching LDL-C target. Increasing age and lower body mass index were associated with reaching goal TC/HDL-C.


CONCLUSIONS
The mean absolute changes in lipid values were significant and median lipid levels approached target levels in patients followed at specialized clinic, however the majority of high risk patients are not meeting goal lipid levels.
Klinke
Jennifer A
JA
St. Paul's Hospital Lipid Clinic, Vancouver, Canada.
Málek
Filip
F
Gao
Min
M
Holmes
Dan
D
Frohlich
Jiri J
JJ
D015992:Body Mass Index; D002170:Canada / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000097:blood* / Q000150:complications / Q000517:prevention & control*; D015331:Cohort Studies; D048909:Diabetes Complications; D050171:Dyslipidemias / Q000097:blood* / Q000150:complications / Q000188:drug therapy*; D005260:Female; D005395:Fish Oils / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009525:Niacin / Q000627:therapeutic use; D016491:Peripheral Vascular Diseases / Q000150:complications; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors
D005395:Fish Oils; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents; D008055:Lipids; D009525:Niacin; C030341:salmon oil