title: Persistent dyslipidemia in statin-treated patients: the focus on comprehensive lipid management survey in Swiss patients.
abstract: BACKGROUND
  Statin therapy reduces cardiovascular morbidity and mortality. However, a substantial residual cardiovascular risk can be observed in patients receiving this therapy due to persisting lipid abnormalities as well as to the lack of a systematic global risk-reduction strategy. The objective of the study was to assess the prevalence of dyslipidemia in a cohort of patients living in Switzerland and receiving statin therapy.
  
  
  METHODS
  This cross-sectional study was conducted by 61 primary care physicians, cardiologists, endocrinologists and internists in Switzerland. Patients were consecutive outpatients≥45 years-old, on statin therapy for at least 3 months with available lipid values. A clinical examination and a recording of the latest lipid values on statin therapy were performed in all patients.
  
  
  RESULTS
  A total of 473 patients (age 66.3±9.41 years; 61.9% male) were included in the final analysis. Under statin therapy, 40% of the analysed patients had a normal lipid profile, 32.6% presented increased low-density lipoprotein cholesterol (LDL-C) (3.35±0.88 mmol/L), 28.8% low high-density lipoprotein-cholesterol (HDL-C) (0.95±0.18 mmol/L) and 31.1% elevated triglycerides (2.69±1.04 mmol/L). It is of note that the included population was characterised by a high prevalence of cardiovascular risk factors (86.5% patients had 10-year cardiovascular risk>20%). Nevertheless, the lipid lowering therapy was modified in only 15.4% of the patients.
  
  
  CONCLUSIONS
  Persistent dyslipidemia is a reality in statin-treated patients and may contribute to their residual cardiovascular risk. Therefore, comprehensive lipid management should be preferred to aggressive LDL-C lowering alone. Moreover, strategies to assess and modify the global cardiovascular risk of patients should be taken into account as an important component of primary and secondary prevention.
authors.affiliation: Cardiovascular Center Cardiology, Rämistrasse 100, 8091 Zürich, Switzerland. isabella.sudano@usz.ch
authors.forename: Isabella
authors.initials: I
authors.lastname: Sudano
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Hess
authors.forename: Georg
authors.initials: G
authors.lastname: Noll
authors.forename: Diana
authors.initials: D
authors.lastname: Arnet
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000453:epidemiology; D008076:Cholesterol, HDL / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000097:blood / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D013557:Switzerland / Q000453:epidemiology; D014280:Triglycerides / Q000097:blood
chemical_list: D008076:Cholesterol, HDL; D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014280:Triglycerides