title: Current cholesterol guidelines and clinical reality: a comparison of two cohorts of coronary artery disease patients.
abstract: BACKGROUND
  Low density lipoprotein (LDL) cholesterol is a causative factor in coronary artery disease, and LDL cholesterol lowering by statins is a cornerstone in cardiovascular risk management. Current guidelines recommend serum LDL cholesterol <70 mg/dl for patients at very high risk, in particular for those with coronary arterial disease (CAD) or type 2 diabetes (T2DM). We aimed to investigate the proportion of patients achieving current lipid goals in two high-risk cohorts of CAD patients.
  
  
  METHODS
  We obtained lipid profiles for two cohorts of patients who underwent coronary angiography for the evaluation of previously (>1 month) established CAD in 1999-2000 (n = 346) and in 2005-2007 (n = 850), at baseline and after 2 years of follow-up.
  
  
  RESULTS
  Overall, the proportion of patients with baseline LDL cholesterol <70 mg/dl was 6.1% in the first and 7.3% in the second cohort (p = 0.236). In logistic regression analysis, male gender (odds ratio [OR] 1.33, 95% confidence interval [CI] 1.11-2.96; p = 0.021) and presence of diabetes (OR 1.76, 95% CI 1.30-2.38; p <0.001) were independent predictors for reaching this LDL cholesterol treatment goal. After 2 years of follow-up, the proportion of patients with LDL cholesterol <70 mg/dl was 1.3% in the first and 9.5% in the second cohort (p <0.001 for the comparison between the two cohorts; p = 0.001 for the comparison of cohort I at baseline vs after 2 years and p = 0.001 for the comparison of cohort II at baseline vs after 2 years).
  
  
  CONCLUSIONS
  The proportion of CAD patients meeting current lipid treatment goals is low and has only slightly improved.
authors.affiliation: Vorarlberg Institute for Vascular Investigation and Treatment (VIVIT), Feldkirch, Austria. alexander.vonbank@lkhf.at
authors.forename: Alexander
authors.initials: A
authors.lastname: Vonbank
authors.forename: Christoph H
authors.initials: CH
authors.lastname: Saely
authors.forename: Philipp
authors.initials: P
authors.lastname: Rein
authors.forename: Daniel
authors.initials: D
authors.lastname: Sturn
authors.forename: Heinz
authors.initials: H
authors.lastname: Drexel
mesh_terms: D000368:Aged; D008078:Cholesterol, LDL / Q000097:blood*; D015331:Cohort Studies; D015897:Comorbidity; D003324:Coronary Artery Disease / Q000097:blood* / Q000150:complications / Q000188:drug therapy; D003924:Diabetes Mellitus, Type 2 / Q000150:complications*; D005260:Female; D019983:Guideline Adherence / Q000706:statistics & numerical data*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D017410:Practice Guidelines as Topic; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors