title: Suboptimal achievement of low-density lipoprotein cholesterol targets in French patients with coronary heart disease. Contemporary data from the DYSIS II ACS/CHD study.
abstract: BACKGROUND
  European guidelines recommend a low-density lipoprotein cholesterol (LDL-C) target of<1.8mmol/L (70mg/dL), and/or a≥50% reduction when the target level cannot be reached, for patients at very high cardiovascular risk, and high-potency lipid-lowering therapy (LLT) in patients with an acute coronary syndrome (ACS).
  
  
  OBJECTIVE
  To document the prevalence of lipid abnormalities and the achievement of lipid targets among patients surviving an ACS and in patients with stable coronary heart disease (CHD), using data from the DYSIS II study.
  
  
  METHODS
  DYSIS II was an observational cross-sectional study conducted in 21 countries (2012-2014). We report data from the French cohort, comprising patients hospitalized with an ACS and patients diagnosed with stable CHD. Data on patient characteristics, risk factors, treatments and lipid profile were collected. LDL-C target achievement was assessed based on the European guidelines endorsed by the French Society of Cardiology.
  
  
  RESULTS
  Of the 468 ACS patients, 277 (59.2%) were receiving LLT at admission to hospital; 22.6% were hospitalized for a recurrent event. Statins were used in 96.6% (450/466) of patients at discharge and in 95.1% (310/326) at 120-day follow-up, at which time 50.6% (80/158) of patients with available data achieved the LDL-C goal. Most of the 436 patients with stable CHD (97.2%) were on LLT (56.8% on high-intensity therapy); 29.2% of patients on LLT met the LDL-C treatment target<1.8mmol/L (70mg/dL).
  
  
  CONCLUSIONS
  These observational data show the progress made in the treatment of ACS from the acute phase up to 3 months, and highlight key areas for improvement in the prevention of recurrent events in patients with CHD in France. The use of higher intensity or combination LLT as recommended in secondary prevention are needed to increase the achievement of LDL-C treatment targets and reduce the risk of morbidity and mortality due to CHD.
authors.affiliation: Department of Cardiology B, Toulouse Rangueil University Hospital (CHU), TSA 50032, 31059 Toulouse cedex, France; UMR 1027, Department of Epidemiology and Public Health, Inserm, université de Toulouse, Toulouse, France. Electronic address: jean.ferrieres@univ-tlse3.fr.
authors.forename: Jean
authors.initials: J
authors.lastname: Ferrières
authors.affiliation: MSD France, Paris, France.
authors.forename: Maja Velkovski
authors.initials: MV
authors.lastname: Rouyer
authors.affiliation: MSD, Vienna, Austria.
authors.forename: Dominik
authors.initials: D
authors.lastname: Lautsch
authors.affiliation: Merck and Co Inc, Kenilworth, NJ, USA.
authors.forename: Veronica
authors.initials: V
authors.lastname: Ashton
authors.affiliation: Merck and Co Inc, Kenilworth, NJ, USA.
authors.forename: Baishali M
authors.initials: BM
authors.lastname: Ambegaonkar
authors.affiliation: Merck and Co Inc, Kenilworth, NJ, USA.
authors.forename: Philippe
authors.initials: P
authors.lastname: Brudi
authors.affiliation: Herzzentrum Ludwigshafen, Medizinische Klinik B, Kardiologie, Ludwigshafen, Germany.
authors.forename: Anselm K
authors.initials: AK
authors.lastname: Gitt
mesh_terms: D054058:Acute Coronary Syndrome / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D000368:Aged; D000369:Aged, 80 and over; D000924:Anticholesteremic Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D008078:Cholesterol, LDL / Q000097:blood*; D003430:Cross-Sectional Studies; D004359:Drug Therapy, Combination; D050171:Dyslipidemias / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005602:France / Q000453:epidemiology; D019983:Guideline Adherence; D006801:Humans; D008297:Male; D008875:Middle Aged; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D015995:Prevalence; D012008:Recurrence; D012307:Risk Factors; D055502:Secondary Prevention / Q000379:methods* / Q000592:standards; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000924:Anticholesteremic Agents; D015415:Biomarkers; D008078:Cholesterol, LDL
keywords: Coronary heart disease; Hyperlipidaemia; Hyperlipidémie; LDL-cholesterol; LDL-cholestérol; Maladie coronaire; Objectif; Statines; Statins; Target