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학술저널
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한국지질동맥경화학회(구 한국지질학회) 지질·동맥경화학회지 지질·동맥경화학회지 제8권 제2호
발행연도
2019.1
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242 - 251 (10page)

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Dyslipidemia and Rate of Under-Target Low-Density Lipoprotein-Cholesterol in Patients with Coronary Artery Disease in Korea Sang-Hak Lee,1 Woo-Hyuk Song,2 Myung Ho Jeong,3 Seung-Ho Hur,4 Dong Woon Jeon,5 Wonju Jeung,6 Anselm K Gitt,7,8 Martin Horack,7 Ami Vyas,9,* Dominik Lautsch,10 Baishali Ambegaonkar,10 Philippe Brudi,10 and Yangsoo Jang1 1Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea. 2Cardiovascular Division, Department of Internal Medicine, Korea University Ansan Hospital, Ansan, Korea. 3Department of Cardiovascular Medicine, Chonnam National University Hospital, Gwangju, Korea. 4Department of Cardiology, Keimyung University Hospital, Daegu, Korea. 5Division of Cardiology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea. 6Merck Sharp & Dohme (MSD), Seoul, Korea. 7Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany. 8Klinikum der Stadt Ludwigshafen, Medizinische Klinik B, Ludwigshafen, Germany. 9Department of Epidemiology, School of Public Health, Rutgers University, Piscataway, NJ, USA. 10Merck & Co., Inc., Kenilworth, NJ, USA. Correspondence to Yangsoo Jang. Division of Cardiology, Department of Internal Medicine, Severance Hospital, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seodaemun-gu, Seoul 03722, Korea. Email: jangys1212@yuhs.ac * *Current address: Department of Pharmacy Practice, College of Pharmacy, University of Rhode Island, Kingston, RI, USA. Received March 25, 2019; Revised July 18, 2019; Accepted August 06, 2019. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Go to: Abstract 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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참고문헌 (21)

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Baigent C / 2005 / Efficacy and safety of cholesterollowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins / Lancet 366:1267~1278 google schola Catapano AL / 2016 / 2016 ESC/EAS guidelines for the management of dyslipidaemias / Eur Heart J 37:2999~3058 google schola Waters DD / 2009 / Lipid treatment assessment project 2: a multinational survey to evaluate the proportion of patients achieving low-density lipoprotein cholesterol goals / Circulation 120:28~34 google schola Gitt AK / 2012 / Persistent lipid abnormalities in statin-treated patients and predictors of LDL-cholesterol goal achievement in clinical practice in Europe and Canada / Eur J Prev Cardiol 19:221~230 google schola Sung J / 2014 / Lipid-lowering treatment practice patterns in Korea: comparison with the data obtained from the CEPHEUS Pan-Asian study / J Atheroscler Thromb 21:1219~1227 google schola

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