title: Achieving optimal lipid values in patients with dyslipidemia is associated with reduced risk of cardiovascular events.
abstract: BACKGROUND
  Cardiovascular (CV) event risk is significantly lower in patients with combined low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C), and triglycerides (TG) at desired levels versus those without lower levels. However, this has not been investigated relative to specific patterns of baseline lipid abnormalities.
  
  
  OBJECTIVE
  To evaluate the association between desired combined lipid value achievement and risk of CV events in patients with different baseline lipid profiles.
  
  
  METHODS
  A retrospective managed care database analysis among treatment-naïve adults with elevated CV event risk, ≥12 months follow-up, and full lipid panel from January 1, 2001 to December 31, 2001 plus ≥1 panel before a CV event or study end. Patients were stratified into three baseline cohorts: isolated high LDL-C (Cohort 1), high LDL-C + low HDL-C or high TG (Cohort 2), and high LDL-C, low HDL-C, and high TG (Cohort 3). CV event risk stratified by combined desired lipid value achievement was assessed in each cohort.
  
  
  RESULTS
  Achievement of combined desired lipid values/median days to achievement was 29% in 385 days (Cohort 1), 11% in 413 days (Cohort 2), and 7% in 505 days (Cohort 3). Achievement of combined desired lipid values was associated with an adjusted 25%-46% lower CV event risk in Cohort 1 (hazards ratio, 0.75; 95% confidence interval 0.65-0.87), Cohort 2 (hazards ratio, 0.54; 95% confidence interval 0.43-0.67), and Cohort 3 (hazard ratio, 0.54; 95% confidence interval 0.37-0.78).
  
  
  CONCLUSIONS
  Patients with combined desired lipid values had lower risk of CV events versus those without such values. The risk reduction was greatest among patients with multiple lipid abnormalities, suggesting a potential benefit of interventions targeting low HDL-C and/or high TG in addition to high LDL-C.
authors.affiliation: University of Colorado, School of Pharmacy, Denver, CO, USA.
authors.forename: Scott L
authors.initials: SL
authors.lastname: Charland
authors.forename: Mark J
authors.initials: MJ
authors.lastname: Cziraky
authors.forename: Ralph
authors.initials: R
authors.lastname: Quimbo
authors.forename: Richard H
authors.initials: RH
authors.lastname: Karas
authors.forename: William
authors.initials: W
authors.lastname: Insull
authors.forename: Michael
authors.initials: M
authors.lastname: Davidson
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Stanek