Correlates of LDL-cholesterol goal attainment in patients under lipid lowering therapy.
BACKGROUND
LDL-cholesterol therapeutic objectives attainment under lipid lowering therapy remains inadequate. The correlates of LDL-cholesterol therapeutic objective attainment have not been thoroughly explored in an observational setting.


METHODS
Patients under lipid lowering therapy and managed by general practitioners were included. LDL-cholesterol therapeutic objective was defined according to the number of cardiovascular risk factors associated with dyslipidemia (AFSSAPS-2005 guidelines).


RESULTS
Most of the 2727 patients (mean age: 64.7+/-11.0) received a statin (70.0%) or a fibrate (24.3%) in monotherapy. 58.5% of patients at high cardiovascular risk did not reach therapeutic objective. Compared to simvastatin, patients receiving fibrates were less likely to be at therapeutic objective (OR=0.38, 95% CI=[0.26-0.54]). So were patients receiving fluvastatin (OR=0.41, IC95%=[0.26-0.64]) or pravastatin (OR=0.49, IC95%=[0.35-0.70]) at the dosages used by GPs. No significant difference appeared with atorvastatin (OR=0.99, 95% CI=[0.71-1.39]) or rosuvastatin (OR=1.25, CI95%=[0.77-2.02]). Patients with LDL-cholesterol levels<0.7 g/L tended to be prescribed high doses of lipid lowering therapy.


CONCLUSIONS
In real conditions of lipid lowering therapy use, LDL-cholesterol therapeutic objective attainment was inadequate in high-risk patients, and TO differences were observed between drugs at prescribed doses.
Laforest
Laurent
L
CHU Lyon, Unité de Pharmacoépidémiologie, Service Neurologie, Hopital Pierre, Wertheimer, Bron F-69677, France.
Moulin
Philippe
P
Souchet
Thierry
T
Ritleng
Cécile
C
Desamericq
Gaëlle
G
Le Jeunne
Philippe
P
Schwalm
Marie-Sophie
MS
Kieffer
Alexia
A
Van Ganse
Eric
E
D000368:Aged; D000924:Anticholesteremic Agents / Q000494:pharmacology; D002319:Cardiovascular System / Q000378:metabolism; D008078:Cholesterol, LDL / Q000378:metabolism*; D005229:Fatty Acids, Monounsaturated / Q000494:pharmacology; D005260:Female; D005464:Fluorobenzenes / Q000494:pharmacology; D000077340:Fluvastatin; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000494:pharmacology; D007211:Indoles / Q000494:pharmacology; D008055:Lipids / Q000737:chemistry*; D008297:Male; D008875:Middle Aged; D017035:Pravastatin / Q000494:pharmacology; D011743:Pyrimidines / Q000494:pharmacology; D012307:Risk Factors; D000068718:Rosuvastatin Calcium; D013449:Sulfonamides / Q000494:pharmacology; D016896:Treatment Outcome
D000924:Anticholesteremic Agents; D008078:Cholesterol, LDL; D005229:Fatty Acids, Monounsaturated; D005464:Fluorobenzenes; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D007211:Indoles; D008055:Lipids; D011743:Pyrimidines; D013449:Sulfonamides; D000077340:Fluvastatin; D000068718:Rosuvastatin Calcium; D017035:Pravastatin