Factors Associated with Lipid Goal Attainment among Patients with Deployed Drug Eluting Stent.
BACKGROUND
Drug-eluting stents (DES) have provided significant benefits for patients with complex coronary lesions. Intensive lipid control through statin therapy decreases the risk of late target lesion revascularization in patients with implanted DES. Therefore, we investigated lipid management in patients with implanted DES and analyzed the predictors for achieving target lipid goals.


METHODS
A retrospective study was performed on consecutive patients who underwent percutaneous coronary intervention (PCI) with DES deployment from 2010 to 2012. Fasting lipid profiles were obtained for all patients both on the day of and 6 months after PCI. Logistic regression analysis was used to predict factors for achieving target lipid goals.


RESULTS
A total of 419 patients (mean age: 62; 80% men) were included. Only 20.8% of patients achieved the target low-density lipoprotein cholesterol (LDL-C) level of < 70 mg/dL, and 61.6% of patients achieved the target LDL-C level of < 100 mg/dL. An equivalent dose of statins was statistically significant in attaining LDL-C levels of < 70 mg/dL [adjusted odds radio (AOR): 1.30; p < 0.001] and < 100 mg/dL (AOR: 1.27; p < 0.001). In addition, a baseline LDL-C level < 130 mg/dL is a leading predictor of achieving target LDL-C levels (AOR: 2.3, p = 0.012 for LDL-C < 70 mg/dL; AOR: 2.01, p = 0.006 for LDL-C < 100 mg/dL).


CONCLUSIONS
Achievement of target LDL-C levels is difficult in patients with implanted DES and a baseline LDL-C level of ≥130 mg/dL who are not treated with statins. Therefore, these patients should be treated with more aggressive statin therapy.


BACKGROUND
Drug-eluting stents; Low density lipoprotein.
Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei;
Min-I
MI
Su
Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei;
Cheng-Ting
CT
Tsai
Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei; ; Mackay Medical College, New Taipei City, Taiwan.
Hung-I
HI
Yeh
Division of Cardiology, Department of Internal Medicine, Mackay Memorial Hospital, Taipei; ; Mackay Medical College, New Taipei City, Taiwan.
Chun-Yen
CY
Chen