Cholesterol goal achievement and lipid-lowering therapy in patients with stable or acute coronary heart disease in Singapore: results from the Dyslipidemia International Study II.
- Author:
Kian-Keong POH
1
;
Chee Tang CHIN
2
;
Khim Leng TONG
3
;
Julian Ko Beng TAN
4
;
Jee Seong LIM
5
;
Weixuan YU
6
;
Martin HORACK
7
;
Ami VYAS
8
;
Dominik LAUTSCH
9
;
Baishali AMBEGAONKAR
9
;
Philippe BRUDI
9
;
Anselm K GITT
7
Author Information
- Publication Type:Journal Article
- Keywords: acute coronary syndrome; coronary artery disease; ezetimibe; hyperlipidaemia; statins
- From:Singapore medical journal 2019;60(9):454-462
- CountrySingapore
- Language:English
-
Abstract:
INTRODUCTION:Dyslipidaemia is a major risk factor for coronary heart disease (CHD). There is a lack of data on the extent of lipid abnormalities and lipid-lowering therapy (LLT) in Singapore.
METHODS:The Dyslipidemia International Study (DYSIS) II was a multinational observational study of patients with stable CHD and hospitalised patients with an acute coronary syndrome (ACS). A full lipid profile and use of LLT were documented at baseline, and for the ACS cohort, at four months post-hospitalisation.
RESULTS:325 patients were recruited from four sites in Singapore; 199 had stable CHD and 126 were hospitalised with an ACS. At baseline, 96.5% of the CHD cohort and 66.4% of the ACS cohort were being treated with LLT. In both cohorts, low-density lipoprotein cholesterol (LDL-C) levels were lower for the treated than the non-treated patients; accordingly, a higher proportion of patients met the LDL-C goal of < 70 mg/dL (CHD: 28.1% vs. 0%, p = 0.10; ACS: 20.2% vs. 0%, p < 0.01). By the four-month follow-up, a higher proportion of the ACS patients that were originally not treated with LLT had met the LDL-C goal (from 0% to 54.5%), correlating with the increased use of medication. However, there was negligible improvement in the patients who were treated prior to the ACS.
CONCLUSION:Dyslipidaemia is a significant concern in Singapore, with few patients with stable or acute CHD meeting the recommended European Society of Cardiology/European Atherosclerosis Society goal. LLT was widely used but not optimised, indicating considerable scope for improved management of these very-high-risk patients.
