Lipid-lowering therapy using statins in patients with cardiovascular risk in clinical practice in Thailand.
BACKGROUND
Since the release in Thailand in 2001 of the Third Guidelines by the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults or the Adult Treatment Panel (ATP III), there have been no nationwide studies on the proportion of dyslipidaemic patients who have achieved the low-density lipoprotein cholesterol (LDL-C) goals. The authors therefore aimed to estimate the percentage achievement of LDL-C goals based on the modified NCEP ATP III guidelines in intermediate- to high-risk patients.


METHODS
The authors conducted a hospital-based, cross-sectional, epidemiological survey. Patients (1240) were selected consecutively from 50 hospitals across Thailand. Patients were included if they had been treated with statins for at least 3 months.


RESULTS
Two-thirds were female, and the mean age was 61.7±9.5 years. The median duration of statin treatment was 21 months. Half (633/ 1240) of the patients achieved the LDL-C goal levels as defined by the NCEP guidelines (51.1%, 95% CI 48.3% to 53.8%). The very-high-risk group had the lowest percentage achievement (11.6%; 95% CI 1.6% to 21.6%), compared with 54.2% (95% CI 50.9% to 57.4%) for the high-risk group and 47.0% (95% CI 41.1% to 52.8%) for the moderate-risk group. More males achieved the LDL-C goals than females (55.6% vs 48.9%; p=0.029).


CONCLUSIONS
Overall, 51.1% of the patients with cardiovascular risk, on statins treatment, achieved the NCEP ATP III LDL-C goal levels.
Department of Medicine, Khon Kaen University, Khon Kaen, Thailand.
Songkwan
S
Silaruks
Her Majesty's Cardiac Center, Department of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand.
Charn
C
Sriratanasathavorn
Endocrinology Unit, BMA Medical College, Vajira Hospital, Thailand.
Petch
P
Rawdaree
Vichaiyut Hospital, Thailand.
Rapeephon
R
Kunjara-Na-Ayudhaya
Department of Biostatistics and Demography, University, Khon Kaen, Thailand.
Bandit
B
Thinkhamrop
Department of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Piyamitr
P
Sritara
Cardiovascular epidemiology; antihypertensive drugs; cardiovasclar examination; coronary risk factors; dyslipidaemia; lipid trials; valvuloplasty