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KMID : 1036020190080020242
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지질.동맥경화학회지
2019 Volume.8 No. 2 p.242 ~ p.251
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Dyslipidemia and Rate of Under-Target Low-Density Lipoprotein-Cholesterol in Patients with Coronary Artery Disease in Korea
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Lee Sang-Hak
Song Woo-Hyuk
Jeong Myung-Ho
Hur Seung-Ho
Jeon Dong-Woon
Jeung Won-Ju
Gitt Anselm K.
Horack Martin
Vyas Ami
Lautsch Dominik
Ambegaonkar Baishali
Brudi Philippe
Jang Yang-Soo
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Abstract
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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.
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KEYWORD
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Cholesterol, Hydroxymethylglutaryl-CoA reductase inhibitors, Acute coronary syndrome, Coronary artery disease, Dyslipidemias
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