Lipid metabolism parameters dynamics in patients who have not previously reached the target values of low-density lipoprotein cholesterol

• Vadim V. Tyrenko
• Aleksey E. Nikitin
• Denis E. Rozhkov
• Svetlana S. Osipova
• Elena B. Kireeva

Abstract

Large studies have shown that a reduction in the cardiovascular disease (CVD) risk is directly proportional to a decrease in low-density lipoprotein cholesterol (LDL-C) levels. Nevertheless, there remains a large number of patients who do not reach the target LDL-C concentrations, which greatly threatens the effectiveness of preventive measures, both at the individual and at the population levels.

The aim - obtaining real clinical data on the dynamics of patients at various CVD risk who did not reach the target LDL-C levels previously state.

Methods. The initial population was presented by men (n=95) with a known CVD risk level from 40 to 65 years (mean age 55.19±6.17 years), who at the time of their initial visit to the clinic in 2017 did not reach the target levels of LDL-C and were examined again.

Results. The average time between visits was 750.8±483.4 days. The proportion of very high CVD risk patients significantly increased (from 66.3 to 81.1%, χ²<0.001). The number of patients who was not taking statins dropped from 56.8 to 45.3%. However, only 27.4% received more intensive lipid-lowering therapy at the time of the second visit, despite the previously received relevant recommendations. Average levels of LDL-C in dynamics significantly decreased: 3.97±1.09 mmol/L at the beginning of the study and 2.90±1.12 mmol/L at the second visit (p<0.001). Among all patients who previously did not reach target LDL-C levels, only 20.0% achieved these values during the follow-up period.

Conclusion. The average lipid concentration over time decreases compared to baseline values, more and more of the observed patients are taking statins and reaching target lipid levels. Nevertheless, the conducted study indicates the low effectiveness of recommendations for correcting lipid metabolism in real clinical practice - only a small part of patients followed the recommendations, and among those who did, only few reached the target LDL-C levels.

Keywords:dyslipidemia; target level of low-density lipoprotein cholesterol; statins; effectiveness of lipidlowering therapy; cardiovascular disease prevention

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