Low-density lipoprotein cholesterol target achievement in patients at high risk for coronary heart disease

Although improvement in target lipid achievement has been observed in recent studies, a significant proportion of patients still do not reach their recommended low-density lipoprotein (LDL-C) targets. We conducted a study in high-risk patients to evaluate the success rate in attaining LDL-C goals.

Medical records of patients referred for cardiac stress testing were reviewed. Demographic data, coronary heart disease (CHD) risk factors, and the most recent lipid profile were recorded. The patients who did not achieve LDL-C target on initial evaluation were reassessed in 12 months.

A total of 765 patients were classified as high-risk CHD. The average age was 66 ± 12 years; 62% were men, and 29% had a previous history of CHD. The mean LDL-C was 96 ± 35 mg/dL and the LDL-C goal of less than 100 mg/dL was achieved in 62%. In 217 patients with very high CHD risk, 83% had LDL-C less than 100 mg/dL and 37% had LDL-C less than 70 mg/dL. At month 12, data from 267 patients were reviewed, and 161 patients (60%) reached LDL-C less than 100 mg/dL. The mean LDL-C was 131 ± 27 mg/dL and 100 ± 29 mg/dL (P < .001) at month 0 and 12, respectively. Antihyperlipidemics were initially prescribed in 49% of these patients and 71% at month 12 (P < .001).

Our study confirms an improving trend in lipid goal attainment in high and very high CHD-risk patients, but despite this, certain high- and very high-risk patients may require more aggressive intervention.