Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2016;69:931-8 - Vol. 69 Num.10 DOI: 10.1016/j.rec.2016.02.012

Degree of Lipid Control in Patients With Coronary Heart Disease and Measures Adopted by Physicians. REPAR Study

Enrique Galve a,, Alberto Cordero b, Angel Cequier c, Emilio Ruiz d, José Ramón González-Juanatey e

a Servicio de Cardiología, Hospital General Universitario Vall d’Hebron, Barcelona, Spain
b Departamento de Cardiología, Hospital de San Juan, San Juan de Alicante, Alicante, Spain
c Servicio de Cardiología, Hospital Universitario de Bellvitge, L’Hospitalet de Llobregat, Barcelona, Spain
d Ferrer Internacional, Barcelona, Spain
e Departamento de Cardiología, Complejo Hospitalario Universitario, Santiago de Compostela, A Coruña, Spain

Refers to

Insufficient Lipid Control in Patients With Coronary Artery Disease: An Unresolved Problem
Alfredo Renilla, Sergio Hevia, Vicente Barriales
Rev Esp Cardiol. 2016;69:996-7
Full text - PDF

Keywords

Dyslipidemia. Coronary heart disease. Observational study. Target values.

Abstract

Introduction and objectives

Lipid control is insufficient in patients with coronary heart disease but this situation may be improving with the implementation of the latest clinical practice guidelines. The aim of this study was to analyze whether target values of low-density lipoprotein cholesterol are achieved and to identify associated factors and physicians’ attitudes to deficient control.

Methods

We conducted a national, multicenter, prospective, observational study of 1103 patients with stable coronary heart disease, analyzing lipid values and a broad set of clinical variables. The statistical analysis involved a binary logistic regression model using backward stepwise elimination.

Results

Low-density lipoprotein cholesterol was < 70 mg/dL in only 26% of patients, even though 95.3% were receiving cholesterol-lowering agents, 45% of which were high-intensity therapies. Independent predictors of low-density lipoprotein cholesterol < 70 mg/dL were diabetes mellitus, wholegrain bread, shorter history of dyslipidemia, and, especially, high-intensity cholesterol-lowering therapies. Physicians increased therapy in only 26% of poorly controlled patients. The main predictor of increased therapy was low-intensity baseline therapy (odds ratio = 5.05; 95% confidence interval, 3.3-9.2). A more proactive approach was observed in older physicians (P = .019) and longer physician practice (P = .02).

Conclusions

Despite the new guidelines, only 26% of patients with coronary heart disease have adequate lipid control. In 70% of patients, physicians continue the same therapy, even though high-intensity cholesterol-lowering therapies are a key factor in good control.

1885-5857/© 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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