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Dyslipidemia and Rate of Under-Target Low-Density Lipoprotein-Cholesterol in Patients with Coronary Artery Disease in Korea

Journal of Lipid and Atherosclerosis 2019년 8권 2호 p.242 ~ 251
 ( Lee Sang-Hak ) - Yonsei University College of Medicine Severance Hospital Department of Internal Medicine

 ( Song Woo-Hyuk ) - Korea University Ansan Hospital Department of Internal Medicine
정명호 ( Jeong Myung-Ho ) - Chonnam National University Hospital Department of Cardiovascular Medicine
 ( Hur Seung-Ho ) - Keimyung University Hospital Department of Cardiology
 ( Jeon Dong-Woon ) - National Health Insurance Service Ilsan Hospital Department of Internal Medicine
 ( Jeung Won-Ju ) - MSD Korea
 ( Gitt Anselm K. ) - Stiftung Institut fur Herzinfarktforschung
 ( Horack Martin ) - Stiftung Institut fur Herzinfarktforschung
 ( Vyas Ami ) - Rutgers University School of Public Health Department of Epidemiology
 ( Lautsch Dominik ) - Merck & Co. Inc.
 ( Ambegaonkar Baishali ) - Merck & Co. Inc.
 ( Brudi Philippe ) - Merck & Co. Inc.
 ( Jang Yang-Soo ) - Yonsei University College of Medicine Severance Hospital Department of Internal Medicine


Objective: The aim of this study was to evaluate under target rates of low-density lipoprotein-cholesterol (LDL-C) in Korean patients with stable coronary artery disease (CAD) or an acute coronary syndrome (ACS) in real world practice.

Methods: Dyslipidemia International Study II was an international observational study of patients with stable CAD or an ACS. Lipid profiles and use of lipid-lowering therapy (LLT) were documented at enrollment, and for the ACS cohort, 4 months follow-up was recommended. Rates of under target LDL-C as per European guidelines, were evaluated, and multivariate regression was performed to identify predictive factors of patients presenting under the target.

Results: A total of 808 patients were enrolled in Korea, 500 with stable CAD and 308 with ACS. Of these, 90.6% and 52.6% were being treated with LLT, respectively. In the stable CAD group, 40.0% were under target LDL-C, while in ACS group, the rate was 23.7%. A higher statin dose was independently associated with under target LDL-C in both groups (OR, 1.03; p=0.046 [stable CAD] and OR, 1.05; p=0.01 [ACS]). The mean statin dosage (atorvastatin equivalent) was 17 mg/day. In the 79 ACS patients who underwent the follow-up examination, the LDL-C under target rate rose to 59.5%.

Conclusion: Only a minority of patients with stable CAD or ACS were under their target LDL-C level at enrollment. The statin dose was not sufficient in the majority of patients. These results indicate a considerable LLT gap in Korean patients with established CAD.


Cholesterol; Hydroxymethylglutaryl-CoA reductase inhibitors; Acute coronary syndrome; Coronary artery disease; Dyslipidemias
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