title: [Achieving optimal cholesterol levels in patients with chronic ischemic heart disease: from guidelines to the real world].
abstract: BACKGROUND
  It is known that less than half of patients with coronary heart disease reaches the target of LDL cholesterol (LDL-C) <100 mg/dl. According to the latest international guidelines, this target has been lowered to <70 mg/dl in very high-risk patients.
  
  
  METHODS
  From November 1, 2009 to December 31, 2012, 4953 patients with coronary heart disease were enrolled in the Cardiovascular Registry of Trieste (Italy). We assessed clinical data, LDL-C levels, statin prescription and medium-term outcome in patients with coronary heart disease.
  
  
  RESULTS
  At first clinical evaluation, LDL-C values were available for only 61.5% of patients. The target level of LDL-C <70 mg/dl was reached in 17% of cases and LDL-C <100 mg/dl in 53%. Patients with lower LDL-C levels were more frequently males, with higher cardiovascular risk profile, more comorbidity and more frequent polypharmacy. LDL-C levels influenced statin prescription: in patients with LDL-C ≥ 100 mg/dl, cardiologists started or modified the dosage of statin therapy twice more than in patients with LDL-C <100 mg/dl, even if only in less than 20% of cases. Patients with LDL-C <100 mg/dl in statin therapy had better prognosis, whereas patients with low LDL-C levels without statin therapy had the worst prognosis. Other prognostic factors in this population with LDL-C <100 mg/dl were age, presence of heart failure, comorbidities (evaluated with Charlson index) and polypharmacy.
  
  
  CONCLUSIONS
  In our population of outpatients with coronary heart disease, the target of LDL-C <100 mg/dl was reached in 53% of cases. LDL-C levels influenced statin prescription and modification of dosages. The medium-term outcome is closely influenced by the achievement of target LDL-C levels and statin prescription.
authors.forename: Antonella
authors.initials: A
authors.lastname: Cherubini
authors.forename: Andrea
authors.initials: A
authors.lastname: Palomba
authors.forename: Marco
authors.initials: M
authors.lastname: Morosin
authors.forename: Giulia
authors.initials: G
authors.lastname: Russo
authors.forename: Carmine
authors.initials: C
authors.lastname: Mazzone
authors.forename: Giulia
authors.initials: G
authors.lastname: Barbati
authors.forename: Luigi
authors.initials: L
authors.lastname: Tarantini
authors.forename: Giovanni
authors.initials: G
authors.lastname: Cioffi
authors.forename: Luigi
authors.initials: L
authors.lastname: Cattin
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Sinagra
authors.forename: Andrea
authors.initials: A
authors.lastname: Di Lenarda
mesh_terms: D000368:Aged; D002318:Cardiovascular Diseases / Q000188:drug therapy; D002784:Cholesterol / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood*; D002908:Chronic Disease; D003327:Coronary Disease / Q000188:drug therapy*; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage / Q000627:therapeutic use*; D007558:Italy; D008297:Male; D017202:Myocardial Ischemia / Q000188:drug therapy*; D010045:Outpatients; D017410:Practice Guidelines as Topic; D011379:Prognosis; D012042:Registries; D012307:Risk Factors; D016896:Treatment Outcome
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D002784:Cholesterol