title: Total lipid management and cardiovascular disease in the dyslipidemia international study.
abstract: OBJECTIVE
  Despite statin use, many patients with cardiovascular disease (CVD) are not achieving treatment goals. An international observational study was performed to estimate the prevalence of residual lipid abnormalities in statin-treated patients with CVD to assess whether lipid management requires improvement.
  
  
  METHODS
  Fasting plasma concentrations of low-density lipoprotein cholesterol (LDL-C), high-density lipoprotein cholesterol (HDL-C) and triglycerides were recorded in 11,104 patients with atherosclerotic CVD and ≥3 months of statin therapy.
  
  
  RESULTS
  LDL-C and total cholesterol were not at goal levels in 41 and 46% of all patients, respectively; for patients with peripheral artery disease (PAD) only, 59 and 65%, respectively, were not at goal, and in those with coronary heart disease only, 38 and 42%, respectively, were not at goal. Patients with cerebrovascular disease only were least frequently observed to have low HDL-C (24%) and elevated triglycerides (36%). Overall, elevated LDL-C was the most frequent lipid anomaly observed, and preexisting heart failure was strongly and positively associated with dyslipidemia.
  
  
  CONCLUSIONS
  Approximately two fifths of statin-treated patients with CVD are not reaching lipid goals or have abnormal lipid levels, while patients with PAD could particularly benefit from improved lipid management. In addition to targeting LDL-C, new evidence-based approaches are needed to target low HDL-C and elevated triglycerides.
authors.affiliation: Department of Cardiology, Toulouse Rangueil University Hospital, Toulouse, France. jean.ferrieres@univ-tlse3.fr
authors.forename: Jean
authors.initials: J
authors.lastname: Ferrières
authors.forename: Vian
authors.initials: V
authors.lastname: Amber
authors.forename: Oliviu
authors.initials: O
authors.lastname: Crisan
authors.forename: François
authors.initials: F
authors.lastname: Chazelle
authors.forename: Claus
authors.initials: C
authors.lastname: Jünger
authors.forename: David
authors.initials: D
authors.lastname: Wood
mesh_terms: D000368:Aged; D002170:Canada / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control*; D002784:Cholesterol / Q000097:blood*; D003430:Cross-Sectional Studies; D050171:Dyslipidemias / Q000097:blood / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D014280:Triglycerides / Q000097:blood*
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D014280:Triglycerides; D002784:Cholesterol