Achievement of LDL-C Targets Defined by ESC/EAS (2011) Guidelines in Risk-Stratified Korean Patients with Dyslipidemia Receiving Lipid-Modifying Treatments

Abstract

Background: This study assessed the proportion of risk-stratified Korean patients with dyslipidemia achieving their low-density lipoprotein cholesterol (LDL-C) targets as defined by the European Society of Cardiology/European Atherosclerosis Society (ESC/ EAS) (2011) guidelines while receiving lipid-modifying treatments (LMTs). Methods: In this multicenter, cross-sectional, observational study, we evaluated data from Korean patients aged ≥19 years who were receiving LMTs for ≥3 months and had an LDL-C value within the previous 12 months on the same LMT. Data were collected for demographics, cardiovascular (CV) risk factors, medical history, and healthcare consumption. Patients were risk-stratified according to the ESC Systematic COronary Risk Evaluation (SCORE) chart and LDL-C target achievement rate was assessed. Results: Guideline-based risk-stratification of the 1,034 patients showed the majority (72.2%) to be in the very high-risk category. Investigators' assessment of risk was underestimated in 71.6% compared to ESC/EAS guidelines. Overall LDL-C target achievement rate was 44.3%; target achievement was the highest (66.0%) in moderate-risk patients and the lowest (39.0%) in very high-risk patients. Overall 97.1% patients were receiving statin therapy, mostly as a single-agent (89.2%). High-intensity statins and the highest permissible dose of high-intensity statins had been prescribed to only 9.1% and 7.3% patients in the very high-risk group, respectively. Physician satisfaction with patients' LDL-C levels was the primary reason for non-intensification of statin therapy. Conclusion: Achievement of target LDL-C level is suboptimal in Korean patients with dyslipidemia, especially in those at very high-risk of CV events. Current practices in LMTs need to be improved based on precise CV risk evaluation posed by dyslipidemia.

Non-achievement of the Low-Density Lipoprotein Cholesterol Goal in Older Patients with Type 2 Diabetes Mellitus and a Very High Cardiovascular Disease Risk: A Multicenter Study in Vietnam

“…The difficulty in managing this very high-risk group was also reported in a recent study in South Korea, which showed that high-intensity statins were prescribed to only 9.1% of patients with very high risk, with 61% of these patients not achieving the LDL-c goal of <1.8 mmol/L. 37 ) Suboptimal doses of statins were observed in several Asian countries in the DYSIS-II study, 38 ) mainly due to concerns about the side effects of higher statin doses satisfaction with patients’ LDL-c levels. 39 ) Our findings highlight the gap between clinical practice and existing guidelines, in that statin utilization remains inadequate, thus contributing to not achieving LDL-C goals.…”

Current Status of Low-Density Lipoprotein Cholesterol Target Achievement in Patients with Type 2 Diabetes Mellitus in Korea Compared with Recent Guidelines

“…Previous studies showed that the LDL-C target goal attainment rate for Korean patients with T2DM was less than 50% [17][18][19][20]. Compared to previous studies with low LDL-C target goal achievement of 17.6% for very-high risk and 47.2% for high risk groups, the recent LDL-C target goal attainment rate has improved.…”

Lipid Management in Korean People With Type 2 Diabetes Mellitus: Korean Diabetes Association and Korean Society of Lipid and Atherosclerosis Consensus Statement

“… 26 When assessing the gap between real-world practice and clinical guidelines, investigators’ assessment of risk was underestimated by 71.6% compared to that by clinical guidelines. 27 Physicians’ perceptions of the target achievement rate of LDL-C were higher than the actual achievement rate (70.6% vs. 47.4%), 28 and physician satisfaction with patients’ LDL-C levels was the primary reason for the non-intensification of statin therapy. 27 …”

“… 27 Physicians’ perceptions of the target achievement rate of LDL-C were higher than the actual achievement rate (70.6% vs. 47.4%), 28 and physician satisfaction with patients’ LDL-C levels was the primary reason for the non-intensification of statin therapy. 27 …”