Related Experiment Videos
[Significant undertreatment of high cholesterol level in ischemic heart disease]
1Kardiologkliniken, Universitetssjukhuset, Linköping. ulf.berglund@lio.se
Insights
Many patients with stable angina have suboptimal low-density lipoprotein (LDL) cholesterol levels, despite guidelines recommending statin therapy for secondary prevention. This highlights a gap in achieving target LDL cholesterol for cardiovascular disease risk reduction.
Area of Science:
- Cardiology
- Lipid Metabolism
- Preventive Cardiology
Context:
- Analysis of 127 patients with stable incapacitating angina undergoing coronary angiography.
- High prevalence (94%) of myocardial ischemia, prior myocardial infarction, or revascularization procedures observed.
- Long average waiting time of 121 days for angiography.
Purpose:
- To assess lipid and lipoprotein profiles in patients with stable angina.
- To evaluate adherence to lipid-lowering guidelines in this patient cohort.
- To identify potential gaps in secondary cardiovascular prevention strategies.
Summary:
- Only one-third of patients achieved recommended low-density lipoprotein (LDL) cholesterol levels (<3.0 mmol/L).
- This finding persists despite established benefits of statin therapy in secondary prevention trials (e.g., 4S, CARE).
- Suboptimal lipid management was noted in a high-risk population with stable angina.
Impact:
- Suggests a need for improved lipid management strategies in stable angina patients.
- Highlights the importance of guideline adherence for secondary cardiovascular prevention.
- Underscores the potential for reducing cardiovascular events through better LDL cholesterol control.
Abstract:
Lipid and lipoprotein analysis was performed in 127 consecutive patients with stable incapaciting angina referred by cardiologists for coronary angiography (mean waiting time, 121 days). Ninety-four per cent of the patients manifested evidence of myocardial ischaemia at exercise testing, or had had earlier myocardial infarction or earlier revascularisation with angioplasty or bypass surgery. Despite the well-known results of the large statin trials in secondary prevention (4S and CARE), only a third of the patients had LDL cholesterol levels in accordance with Swedish and European guidelines, i.e., below 3.0 mmol/L.