Uncontrolled hyperlipidemia in Chinese patients who experienced acute coronary syndrome: an observational study
Jie Jiang1, Yu-Jie Zhou2, Jian-Jun Li3
1Department of Cardiology, Peking University First Hospital, Xicheng District, Beijing 100034, China, yonghuo54@gmail.com.
Insights
Many Chinese patients with recent acute coronary syndrome (ACS) fail to reach lipid goals despite statin therapy. This highlights a need for new treatments to reduce residual cardiovascular risk.
Area of Science:
- Cardiology
- Atherosclerosis Research
- Public Health
Background:
- Hyperlipidemia management in acute coronary syndrome (ACS) patients remains a challenge.
- Suboptimal lipid goal attainment increases residual risk of atherothrombotic events.
- Chinese ACS patients on lipid-lowering treatment often fail to reach targeted lipid levels.
Purpose of the Study:
- To characterize Chinese patients with recent ACS who are on lipid-lowering treatment but not meeting lipid goals.
- To identify factors contributing to the failure in achieving lipid targets in this population.
Main Methods:
- A multicenter, cross-sectional study involving 2,034 Chinese patients with recent ACS (STEMI, NSTEMI, or unstable angina).
- Patients were enrolled within 4-40 weeks of their ACS event and were on statin treatment.
- Fasting lipid tests and medical history data were collected.
Main Results:
- Out of 1,994 eligible patients, 63.8% did not achieve their lipid goals.
- Intensive statin therapy was used in 74.9% of patients.
- Patients not at goal were predominantly male (73.4%), with a mean age of 61.2 years, and high prevalence of hypertension (54.9%) and diabetes (25.3%).
Conclusions:
- A significant majority of Chinese patients with recent ACS on statin therapy do not achieve guideline-recommended lipid goals.
- These findings underscore the unmet need for novel therapeutic strategies beyond statins.
- Further interventions are crucial to reduce the substantial residual cardiovascular disease burden in this high-risk group.
Objective:
Despite current standard of care, the overall lipid goal attainment rate for hyperlipidemia patients, especially those who have experienced acute coronary syndrome (ACS), is suboptimal, which predisposes them to a higher residual risk of atherothrombotic events. This study aimed to describe characteristics of Chinese patients who recently experienced an ACS event and were on lipid-lowering treatment, yet failing to reach targeted goal.
Methods:
A multicenter, cross-sectional study was conducted to recruit 2,034 Chinese patients who experienced an ACS (ST segment elevation myocardial infarction [STEMI], non-STEMI, or unstable angina) event within the past 4-40 weeks and were on statin treatment (>2 weeks) from March 2015 to December 2016. All eligible patients underwent a fasting lipid test after enrollment and data on medical history were collected.
Results:
The mean age of 1,994 eligible patients was 61.0±9.84 years. Among them, 1,493 (74.9%) patients received intensive statin therapy (defined as atorvastatin 40 or 80 mg, or rosuvastatin 20 mg per protocol) and 499 (25.0%) patients were on maximum tolerated dose statin. Of the 1,994 eligible subjects, 1,273 (63.8%) patients did not achieve the lipid goal at the time of enrollment. Among the not-at-goal patients, 910 (71.5%) received intensive statin therapy; the majority (73.4%) of them were male; the mean age was 61.2±10.1 years old; 699 (54.9%) patients had a history of hypertension; 25.3% had diabetes mellitus; and 29.5% were current smokers. The mean low-density lipoprotein-cholesterol (LDL-C), non-high-density lipoprotein-cholesterol (non-HDL-C), and ApoB levels at enrollment of this group of patients were 2.460±0.7139 mmol/L, 3.094±0.8861 mmol/L, and 0.840±0.3015 g/L, respectively.
Conclusion:
The study result demonstrates that overall more than half of the patients who recently (4-40 weeks) experienced ACS who were treated did not reach the guideline-recommended LDL-C and non-HDL-C goal. These results highlight the potential necessity for a new drug beyond statins to further reduce disease burden in the future.
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:30Acute Coronary Syndrome I: Introduction
01:26Acute Coronary Syndrome V: Nursing Management
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:19Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations
01:11Observational Studies
There are three types of observational studies – Prospective, retrospective, and cross-sectional.
Prospective Study
Prospective studies, also known as longitudinal or cohort studies, are carried out by collecting future data from groups sharing similar characteristics. One...