Achievement of the low-density lipoprotein cholesterol goal among patients with dyslipidemia in South Korea

Kim, Siin; Han, Sangheon; Rane, Pallavi; Qian, Yi; Zhao, Zhongyun; Suh, Hae Sun

doi:10.1371/journal.pone.0228472

Cited by 18 publications

(12 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In a recent study published in 2020, 69,942 Korean patients with dyslipidemia were stratified according to the risk, based on the 2015 Korean guidelines as done in our research, and the achievement rate of target LDL-C levels was analyzed. In that study, similar to the previous research published 12 years ago, the achievement rate of target LDL-C levels was very suboptimal as only 17.6% of very high-risk patients and 47.2% of high-risk patients achieved the target [ 27 ]. Also, investigations conducted in other Asian countries reported low LDL-C target achievement rates [ 17 , 19 , 28 ].…”

Section: Discussionsupporting

confidence: 85%

A randomized, open-label, parallel, multi-center Phase IV study to compare the efficacy and safety of atorvastatin 10 and 20 mg in high-risk Asian patients with hypercholesterolemia

et al. 2021

View full text Add to dashboard Cite

Background Although accumulating evidence suggests a more extensive reduction of low-density lipoprotein cholesterol (LDL-C), it is unclear whether a higher statin dose is more effective and cost-effective in the Asian population. This study compared the efficacy, safety, and cost-effectiveness of atorvastatin 20 and 10 mg in high-risk Asian patients with hypercholesterolemia. Methods A 12-week, open-label, parallel, multicenter, Phase IV randomized controlled trial was conducted at ten hospitals in the Republic of Korea between October 2017 and May 2019. High-risk patients with hypercholesterolemia, defined according to 2015 Korean guidelines for dyslipidemia management, were eligible to participate. We randomly assigned 250 patients at risk of atherosclerotic cardiovascular disease to receive 20 mg (n = 124) or 10 mg (n = 126) of atorvastatin. The primary endpoint was the difference in the mean percentage change in LDL-C levels from baseline after 12 weeks. Cost-effectiveness was measured as an exploratory endpoint. Results LDL-C levels were reduced more significantly by atorvastatin 20 mg than by 10 mg after 12 weeks (42.4% vs. 33.5%, p < 0.0001). Significantly more patients achieved target LDL-C levels (<100 mg/dL for high-risk patients, <70 mg/dL for very high-risk patients) with atorvastatin 20 mg than with 10 mg (40.3% vs. 25.6%, p < 0.05). Apolipoprotein B decreased significantly with atorvastatin 20mg versus 10 mg (−36.2% vs. −29.9%, p < 0.05). Lipid ratios also showed greater improvement with atorvastatin 20 mg than with 10 mg (total cholesterol/high-density lipoprotein cholesterol ratio, −33.3% vs. −29.4%, p < 0.05; apolipoprotein B/apolipoprotein A1 ratio, −36.7% vs. −31.4%, p < 0.05). Atorvastatin 20 mg was more cost-effective than atorvastatin 10 mg in terms of both the average and incremental cost-effectiveness ratios. Safety and tolerability of atorvastatin 20 mg were comparable to those of atorvastatin 10 mg. Conclusion In high-risk Asian patients with hypercholesterolemia, atorvastatin 20 mg was both efficacious in reducing LDL-C and cost-effective compared with atorvastatin 10 mg.

show abstract

Section: Discussionsupporting

confidence: 85%

A randomized, open-label, parallel, multi-center Phase IV study to compare the efficacy and safety of atorvastatin 10 and 20 mg in high-risk Asian patients with hypercholesterolemia

et al. 2021

View full text Add to dashboard Cite

show abstract

“…Insufficient management and poor adherence to lipid-lowering treatment has been described in other studies with a large proportion of high- and very high-risk individuals failing to attain their LDL-c goals. [ 9 – 11 , 23 – 25 ] The proportion of people receiving lipid-lowering treatment in the high-risk group in our study is 1 of the lowest described in the literature. This finding could be partially explained by the pronounced distrust among patients in France regarding this therapeutic class.…”

Section: Discussionmentioning

confidence: 65%

“…[ 7 , 8 ] However, several studies have demonstrated under-prescription of statin and non-optimal adherence to these treatments. [ 9 – 11 ] Physician inertia, patient unwillingness and the real or alleged side effects of statins may be implicated in the suboptimal management of dyslipidemia. [ 10 – 12 ] In France, this therapeutic class has been challenged in the lay press and, as a consequence, generates fears with recurring suspicions about its safety and its usefulness.…”

Section: Introductionmentioning

confidence: 99%

Prevalence and management of hypercholesterolemia in France, the Esteban observational study

et al. 2020

View full text Add to dashboard Cite

Hypercholesterolemia is a major risk factor for cardiovascular diseases. However, its management in everyday clinical practice is often suboptimal. The aims of the Esteban study were to estimate the prevalence of hypercholesterolemia and to describe its management in France in 2015. Esteban is a cross-sectional, publicly funded survey, representative of the French population. Data were collected using questionnaires and biological and clinical examinations in 3021 adults aged 18-74. The lipid-lowering treatments were obtained by matching the individual data of the subjects included in the Esteban survey with data from the Système national de données de santé . Hypercholesterolemia was defined as either a low density lipoprotein cholesterol value higher than the goal set in the European Society of Cardiology/European Atherosclerosis Society guidelines as a function of individual cardiovascular risk level, or at least 1 delivery of lipid-lowering treatment. Adherence was defined by the proportion of days covered by the lipid-lowering treatment in the 6 months preceding clinical examination. Prevalence of hypercholesterolemia in France was 23.3% (27.8% in men, 19.0% in women). Mean low density lipoprotein cholesterol was 3.38 mmol/l in French participants. Among them, 7.2% were treated (8.5% of men, 5.8% of women), while 16.1% of adults went untreated (19.3% of men, 13.2% of women). Only 29.7% of secondary prevention adults had a delivery of lipid-lowering treatments in the 6 months preceding clinical examination. Fewer than 1 in 3 treated adults were adherent, i.e. more than 80% of days covered by a treatment. This proportion reached 37.4% in the high-risk group, with no significant difference of adherence in people with or without a personal history of cardiovascular disease in this group. This study showed that hypercholesterolemia is a common metabolic disease in France, affecting 23.3% of the population. Lipid-lowering prescriptions diverged greatly from current recommendations, with less than a third of eligible patients being treated.

show abstract

“…Hence, patients with DM with dyslipidemia in Korea are generally managed with an LDL-C goal < 100 mg/dL. Other studies based in Korea that examined LDL-C goal attainment in patients with dyslipidemia also used LDL-C goal < 100 mg/dL when assessing control of dyslipidemia among patients with DM without CVD [ 31 , 40 ]. In addition, the control rate of patients with DM in this study was already poor despite potential overestimation.…”

Section: Discussionmentioning

confidence: 99%

Prevalence, awareness, treatment, and control of dyslipidemia among diabetes mellitus patients and predictors of optimal dyslipidemia control: results from the Korea National Health and Nutrition Examination Survey

Kim

Kwon²,

Kim

2021

Lipids Health Dis

View full text Add to dashboard Cite

Background This study aimed to investigate the prevalence, awareness, treatment, and control rates of dyslipidemia and identify the predictors of optimal control (low-density lipoprotein cholesterol < 100 mg/dL) among patients with diabetes mellitus (DM). Methods A cross-sectional study was conducted using the representative Korea National Health and Nutrition Examination Survey (2014–2018). Overall, 4311 patients with DM, aged ≥19 years, and without cardiovascular diseases were selected, and the prevalence, awareness, treatment, and control rates of dyslipidemia were calculated. Univariate and multivariate logistic regression analyses were conducted to evaluate the factors influencing the optimal control of dyslipidemia. Results Dyslipidemia was prevalent in 83.3% of patients with DM, but the awareness and treatment rates were 36.5 and 26.9%, respectively. The control rate among all patients with dyslipidemia was 18.8%, whereas it was 61.1% among those being treated. Prevalence and awareness rates were also significantly higher in women than in men. Dyslipidemia was most prevalent in those aged 19–39 years, but the rates of awareness, treatment, and control among all patients with dyslipidemia in this age group were significantly lower than those in other age groups. The predictors of optimal control were age ≥ 40 years [range 40–49 years: adjusted odds ratio (aOR) 3.73, 95% confidence interval (CI) 1.43–9.72; 50–59 years: aOR 6.25, 95% CI 2.50–15.65; 60–69 years: aOR 6.96, 95% CI 2.77–17.44; 70–79 years: aOR 9.21, 95% CI 3.58–23.74; and ≥ 80 years: aOR 4.43, 95% CI 1.60–12.27]; urban living (aOR 1.44, 95% CI 1.15–1.80); higher body mass index (aOR 1.27, 95% CI 1.13–1.42); lower glycated hemoglobin levels (aOR 0.71, 95% CI 0.67–0.76); hypertension (aOR 1.53, 95% CI 1.22–1.92); poorer self-rated health status (aOR 0.72, 95% CI 0.62–0.84); and receiving regular health check-ups (aOR 1.58, 95% CI 1.25–2.00). Conclusions Most patients with DM were diagnosed with dyslipidemia, but many were unaware of or untreated for their condition. Therefore, their control rate was suboptimal. Thus, by understanding factors influencing optimal control of dyslipidemia, physicians should make more effort to encourage patients to undergo treatment and thus, adequately control their dyslipidemia.

show abstract

Achievement of the low-density lipoprotein cholesterol goal among patients with dyslipidemia in South Korea

Cited by 18 publications

References 28 publications

A randomized, open-label, parallel, multi-center Phase IV study to compare the efficacy and safety of atorvastatin 10 and 20 mg in high-risk Asian patients with hypercholesterolemia

A randomized, open-label, parallel, multi-center Phase IV study to compare the efficacy and safety of atorvastatin 10 and 20 mg in high-risk Asian patients with hypercholesterolemia

Prevalence and management of hypercholesterolemia in France, the Esteban observational study

Prevalence, awareness, treatment, and control of dyslipidemia among diabetes mellitus patients and predictors of optimal dyslipidemia control: results from the Korea National Health and Nutrition Examination Survey

Contact Info

Product

Resources

About