title: Attainment of goal and normalized lipid levels with lipid-modifying therapy in Malaysia.
abstract: BACKGROUND
  Although LDL-C is the primary lipid target for coronary heart disease (CHD) risk reduction, HDL-C and triglycerides (TG) have also emerged as CHD risk factors.
  
  
  OBJECTIVE
  The objective of this study was to evaluate goal/normal lipid level attainment after lipid-modifying therapy (LMT) in an ethnically diverse sample of patients in Malaysia.
  
  
  METHODS
  Retrospective, longitudinal data were collected from the medical records of patients aged ≥35 years in whom LMT was initiated between January 2004 and December 2006. Eligible patients had records of full lipid panels 12 months before and after the start of therapy. LDL-C goals and normal levels of HDL-C and TG were defined as per the Clinical Practice Guidelines on Management of Dyslipidemia (4th edition), Malaysia. A subgroup of patients at high risk for CHD events (established CHD, diabetes but no CHD, or a 10-year history of Framingham risk score ≥20%) was also studied.
  
  
  RESULTS
  Among 607 eligible patients (mean age, 57.1 years; 40% male), 89% had elevated LDL-C, 37% had low HDL-C, 56% had elevated TG, and 62% had ≥2 abnormal lipid levels before LMT. Despite therapy (87% statins only), 60% had elevated LDL-C, 37% had low HDL-C, 40% had elevated TG, and 44% continued to have ≥2 abnormal lipid levels.
  
  
  CONCLUSIONS
  In this longitudinal study of Malaysian patients treated with lipid-modifying therapy, primarily using statins, attainment of LDL-C goal is suboptimal. Furthermore, a large proportion of patients do not achieve normal levels of HDL-C and TG. Therefore, patients may benefit from a more comprehensive approach to lipid management that treats all 3 lipid risk factors, as suggested in clinical guidelines.
authors.affiliation: Merck Sharp & Dohme (I.A.) Corp., Singapore Branch, Singapore.
authors.forename: Tun-Ying
authors.initials: TY
authors.lastname: Hsu
authors.forename: Diana
authors.initials: D
authors.lastname: Chirovsky
authors.forename: Foong Ming
authors.initials: FM
authors.lastname: Moy
authors.forename: Baishali M
authors.initials: BM
authors.lastname: Ambegaonkar
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D000960:Hypolipidemic Agents / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood*; D008137:Longitudinal Studies; D008296:Malaysia; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D000960:Hypolipidemic Agents; D008055:Lipids