Lipid goal attainment in post‐acute coronary syndrome patients in China: Results from the 6‐month real‐world dyslipidemia international study <scp>II</scp>

Gong, Yanjun; Li, Xuan; Ma, Xiang; Yu, Hong‐Ren; Liu, Ying; Chen, Jiyan; Zhang, Guochun; Wang, Bin; Qi, Xiaoyong; Hu, Meng; Wang, Xiaofeng; Mu, Jianjun; Hu, Xitian; Wang, Jingping; Liu, Shaowen; Liu, Gang; Yang, Zhenyu; Zhou, Yujie; Kong, Xiangqing; Yan, Yuhu; Wang, Changqian; Wang, Jian An; Wang, Lijun; Fu, Guosheng; Wei, Lin; Peng, Daoquan; Zhang, Shuyang; Li, Ruogu; Mao, Anhua; Bian, Rui; Tang, Wenmin; Ran, Yuqin; Jiang, Jie; Huo, Yong

doi:10.1002/clc.23725

Cited by 10 publications

(10 citation statements)

References 32 publications

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“…Despite the body of evidence from basic scientific investigations, longitudinal cohorts, prospective randomized clinical trials of pharmacological interventions, and various meta-analyses, the majority of high- and very-high-risk patients remain undertreated. 4–6 More aggressive LDL-C reduction correlates with lower risk of myocardial infarction, ischemic stroke, need for coronary and peripheral revascularization, and death and lower rates of progression of atherosclerotic disease. 7,8 Given these observations, it is important to identify and ameliorate barriers to appropriate care to best serve the needs of patients at risk of ASCVD.…”

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confidence: 99%

Aggressive LDL-C Lowering and the Brain: Impact on Risk for Dementia and Hemorrhagic Stroke: A Scientific Statement From the American Heart Association

Goldstein,

Toth,

Dearborn-Tomazos

et al. 2023

ATVB

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The objective of this scientific statement is to evaluate contemporary evidence that either supports or refutes the conclusion that aggressive low-density lipoprotein cholesterol lowering or lipid lowering exerts toxic effects on the brain, leading to cognitive impairment or dementia or hemorrhagic stroke. The writing group used literature reviews, references to published clinical and epidemiology studies, clinical and public health guidelines, authoritative statements, and expert opinion to summarize existing evidence and to identify gaps in current knowledge. Although some retrospective, case control, and prospective longitudinal studies suggest that statins and low-density lipoprotein cholesterol lowering are associated with cognitive impairment or dementia, the preponderance of observational studies and data from randomized trials do not support this conclusion. The risk of a hemorrhagic stroke associated with statin therapy in patients without a history of cerebrovascular disease is nonsignificant, and achieving very low levels of low-density lipoprotein cholesterol does not increase that risk. Data reflecting the risk of hemorrhagic stroke with lipid-lowering treatment among patients with a history of hemorrhagic stroke are not robust and require additional focused study.

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confidence: 99%

Aggressive LDL-C Lowering and the Brain: Impact on Risk for Dementia and Hemorrhagic Stroke: A Scientific Statement From the American Heart Association

Goldstein,

Toth,

Dearborn-Tomazos

et al. 2023

ATVB

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“…The medical records of the DM patients enrolled in this study were extracted from the DYSIS II-China study database. The DYSIS II-China study was a multicenter prospective observational study conducted between September 2017 and May 2019, which aimed to assess LDL-C goal attainment in Chinese patients with ACS [ 11 ]. The inclusion criteria were as follows: (1) age ≥ 18 years old, (2) written informed consent was obtained, (3) hospitalized for ACS, (4) complete lipid profile within 24 h after admission, (5) on LLT for ≥ 3 months at the time of enrollment, or not at all on LLT.…”

Section: Methodsmentioning

confidence: 99%

“…Further analyses based on the global DYSIS II study demonstrated that only 11.3% of type 2 DM patients hospitalized for ACS achieved the LDL-C goal of < 1.4 mmol/L at admission, and this attainment rate was improved to 22.5% at the 4-month follow-up [ 10 ]. For Chinese patients, the DYSIS II-China study aimed to assess the LDL-C goal (< 1.8 mmol/L) attainment rate in post-ACS patients including DM patients, who accounted for 28.6% of the whole population [ 11 ]. Hence, in the present analysis of the DYSIS II-China study, we attempted to specifically investigate the LLT patterns and LDL-C goal attainment of < 1.4 mmol/L at baseline and at 6 months post-ACS in DM patients.…”

Section: Introductionmentioning

confidence: 99%

Lipid goal attainment in diabetes mellitus patients after acute coronary syndrome: a subanalysis of Dyslipidemia International Study II-China

Guo

Chu

Wang

et al. 2023

BMC Cardiovasc Disord

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Background Lipid management with a low-density lipoprotein cholesterol (LDL-C) goal of < 1.4 mmol/L is recommended for patients with acute coronary syndrome (ACS) and diabetes mellitus (DM) due to a high risk for adverse cardiovascular events. This study evaluated the lipid-lowering treatment (LLT) pattern and the LDL-C goal attainment rate in this special population. Methods DM patients were screened from the observational Dyslipidemia International Study II-China study which assessed LDL-C goal attainment in Chinese ACS patients. The baseline characteristics between the LLT and no pre-LLT groups were compared. The proportions of patients obtaining LDL-C goal at admission and at 6-months, the difference from the goal, and the pattern of the LLT regimen were analyzed. Results Totally 252 eligible patients were included, with 28.6% taking LLT at admission. Patients in the LLT group were older, had a lower percentage of myocardial infarction, and had decreased levels of LDL-C and total cholesterol compared to those in the no pre-LLT group at baseline. The overall LDL-C goal attainment rate was 7.5% at admission and increased to 30.2% at 6 months. The mean difference between the actual LDL-C value and LDL-C goal value dropped from 1.27 mmol/L at baseline to 0.80 mmol/L at 6 months. At 6 months, 91.4% of the patients received statin monotherapy, and only 6.9% received a combination of statin and ezetimibe. The atorvastatin-equivalent daily statin dosage was moderate during the study period. Conclusion The low rate of lipid goal attainment observed was in line with the outcomes of other DYSIS-China studies.

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“…Based on the results from "The IMPROVE-IT" study, the target LDL-C < 1.8 mmol/L and < 1.4 mmol/L was achieved with high-intensity simvastatin monotherapy and combination therapy of high-dose simvastatin and ezetimibe respectively. The ODYSSEY Outcomes study showed that the LDL-C level in ACS patients treated with alirocumab was reduced to 1.38 mmol/L [ 20 , 21 ]. The Dyslipidaemia International Study II (DYSIS II) based on data from 10,661 patients from 18 countries demonstrated a significant increase in the percentage of patients followed up after ACS from 65.2% to 95.6%; 93.4% of patients were on statin monotherapy only.…”

Section: Reviewmentioning

confidence: 99%

A Systematic Review of Lipid Management in Secondary Prevention and Comparison of International Lipid Management Pathways

Khan¹,

Gul²,

Yousif³

et al. 2023

Cureus

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Acute coronary syndrome remains a major cause of morbidity and mortality despite significant improvements in its prevention and management. Lipid management and other risk factors such as hypertension, diabetes, obesity, smoking and sedentary lifestyle stratification is the key to minimising this risk. Lipid management is an important part of secondary prevention and patients are historically undertreated after post-acute coronary syndrome. We performed a narrative review on observational studies on lipid management pathways post ACS on PubMed, Google Scholar, Journal Storage and ScienceDirect and excluded case reports, case series and randomized controlled trials. Our review showed that most patients following acute coronary syndrome receive suboptimal treatment for hypercholesterolemia. The role of statin in reducing future cardiac events risk is undisputable, however, statin intolerance remains a major concern. There is substantial variation in the management of lipids in patients following an acute cardiac event and patients were followed up in primary care in some countries and secondary care in others. The mortality risk is significantly high in patients with second or recurrent cardiac events and future cardiac events are associated with higher morbidity and mortality risk. There is significant variation in lipid management pathways in patients who suffer from cardiac events across the globe and lipid therapy optimization remains suboptimal in these patients, putting them at future risk of cardiovascular events. It is therefore imperative to optimally manage dyslipidemia in these patients in order to minimize the risk of subsequent cardiac events. Cardiac rehabilitation programs might be a way forward to incorporate lipid management for patients discharged from the hospital after having acute coronary events for lipid therapy optimization.

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Lipid goal attainment in post‐acute coronary syndrome patients in China: Results from the 6‐month real‐world dyslipidemia international study II

Cited by 10 publications

References 32 publications

Aggressive LDL-C Lowering and the Brain: Impact on Risk for Dementia and Hemorrhagic Stroke: A Scientific Statement From the American Heart Association

Aggressive LDL-C Lowering and the Brain: Impact on Risk for Dementia and Hemorrhagic Stroke: A Scientific Statement From the American Heart Association

Lipid goal attainment in diabetes mellitus patients after acute coronary syndrome: a subanalysis of Dyslipidemia International Study II-China

A Systematic Review of Lipid Management in Secondary Prevention and Comparison of International Lipid Management Pathways

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