Lipid-lowering treatment in patients at high cardiovascular risk discharged from an Italian hospital.
OBJECTIVE
Atherosclerosis is the leading cause of cardiovascular morbidity and mortality in Italy. One of its principal risk factors is dyslipidemia. The aim of our study was to determine the accuracy of antihypercholesterolemic treatment in high-risk patients [low-density lipoprotein (LDL) > 100 mg/dl] discharged from hospital.


METHODS
Among all the patients aged 40-70 years hospitalized at S. Orsola-Malpighi Hospital, Bologna, during 2008, we selected patients who had established arterial disease (coronary artery disease, cerebrovascular disease, peripheral arterial disease) or diabetes; excluding patients with creatine kinase or transaminase alterations, renal function impairment, diagnosis of hypercholesterolemia alone or incomplete lipid profile; the final population included 999 participants. Total cholesterol, high-density lipoprotein cholesterol and triglycerides were measured on blood samples. LDL-cholesterol was obtained by the Friedwald formula. Statin use was evaluated through medical records, comparing admission and discharge. The χ(2)-test was used to compare the percentage of patients on lipid-lowering treatment at admission and discharge.


RESULTS
Considering all 462 individuals with LDL-cholesterol levels more than 100 mg/dl, statin treatment increased from 25.5% at admission to 61.7% at discharge; however, more than 38% of patients who deserved a pharmacological therapy were not treated. In addition, we observed an improvement in lipid-lowering therapy only in 23 patients with LDL-cholesterol levels more than 100 mg/dl already under statin treatment.


CONCLUSIONS
Our data show that dyslipidemia is generally undertreated in high-risk patients, despite the fact that hospitalization brings them in contact with specialized physicians.
Internal Medicine, Aging and Kidney Disease Department, University of Bologna, Bologna, Italy.
Alessandro
A
Spighi
Elisa
E
Tartagni
Sergio
S
D'Addato
Ada
A
Dormi
Claudio
C
Borghi
D000328:Adult; D000368:Aged; D002318:Cardiovascular Diseases / Q000097:blood / Q000209:etiology / Q000517:prevention & control*; D008078:Cholesterol, LDL / Q000097:blood; D003925:Diabetic Angiopathies / Q000517:prevention & control; D004363:Drug Utilization / Q000706:statistics & numerical data; D005260:Female; D006760:Hospitalization; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D006937:Hypercholesterolemia / Q000097:blood / Q000150:complications / Q000188:drug therapy*; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D012189:Retrospective Studies; D012307:Risk Factors
D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors