title: Lipid lowering drug therapy in patients with coronary heart disease from 24 European countries--Findings from the EUROASPIRE IV survey.
abstract: OBJECTIVE
  Since dyslipidaemia is one of the most important risk factors for coronary heart disease (CHD), lowering of LDL-cholesterol (LDL-C) causes significant reduction in morbidity and mortality, particularly in patients with established CHD. The aim of this survey was to assess how statins were prescribed in CHD patients at discharge after a coronary event from hospitals throughout Europe and how the intake of these drugs was reported by the patients when they were seen more than one year later in relationship with their achieved LDL-C levels.
  
  
  METHODS
  6648 CHD patients' data from centres in 24 European countries were gathered using standardized methods. Lipid measurements were performed in one central laboratory. Patients were divided in three groups: high-intensity statin therapy, moderate or low intensity statin therapy and no statin therapy at all.
  
  
  RESULTS
  90.4% CHD patients were on statin therapy at the time of discharge from the hospital which decreased to 86% one year later. Only 37.6% of these patients were prescribed a high-intensity statin at discharge which even decreased to 32.7% later. In only 6 countries (all of them high-income countries) the number of patients on a high-intensity statin therapy increased substantially after the hospital discharge. It is worrying that statin therapy was discontinued in 11.6% and that only 19.3% of all CHD patients achieved target values of LDL-C < 1.8 mmol/L at the time of interview.
  
  
  CONCLUSIONS
  Too many CHD patients with dyslipidaemia are still inadequately treated and most of these patients on statin therapy are not achieving the treatment targets. Therapeutic control of LDL-C is clearly related to the intensity of lipid lowering drug regimen after the CHD event indicating that a considerable potential still exists throughout Europe to reduce CHD mortality and morbidity rates through more efficient LDL-C lowering.
authors.affiliation: Department of Internal Medicine, University Hospital Center Zagreb, School of Medicine, University of Zagreb, Croatia. Electronic address: zreiner@kbc-zagreb.hr.
authors.forename: Ž
authors.initials: Ž
authors.lastname: Reiner
authors.affiliation: Department of Public Health, Ghent University, Ghent, Belgium.
authors.forename: G
authors.initials: G
authors.lastname: De Backer
authors.affiliation: Department of Internal Medicine, University Hospital Centre Ljubljana, University of Ljubljana, Slovenia.
authors.forename: Z
authors.initials: Z
authors.lastname: Fras
authors.affiliation: Cardiovascular Medicine, International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, United Kingdom.
authors.forename: K
authors.initials: K
authors.lastname: Kotseva
authors.affiliation: Department of Cardiology, Hacettepe University, Ankara, Turkey.
authors.forename: L
authors.initials: L
authors.lastname: Tokgözoglu
authors.affiliation: Cardiovascular Medicine, International Centre for Circulatory Health, National Heart and Lung Institute, Imperial College London, United Kingdom.
authors.forename: D
authors.initials: D
authors.lastname: Wood
authors.affiliation: Department of Public Health, Ghent University, Ghent, Belgium.
authors.forename: D
authors.initials: D
authors.lastname: De Bacquer
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000097:blood; D003327:Coronary Disease / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D003430:Cross-Sectional Studies; D011307:Drug Prescriptions; D004359:Drug Therapy, Combination; D017723:Drug Utilization Review; D050171:Dyslipidemias / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D005060:Europe / Q000453:epidemiology; D005260:Female; D019983:Guideline Adherence / Q000639:trends; D019538:Health Care Surveys; D054625:Healthcare Disparities / Q000639:trends; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008055:Lipids / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000639:trends*; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention / Q000639:trends*; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D008055:Lipids
keywords: Coronary heart disease; EUROASPIRE; LDL-Cholesterol; Non-HDL-Cholesterol; Secondary prevention; Statins