Low-density lipoprotein cholesterol goal attainment rates in high-risk patients with cardiovascular diseases and diabetes mellitus in Korea: a retrospective cohort study

• Published in: Lipids in health and disease Vol. 19; no. 1; p. 5
• Main Authors: Yang, Ye Seul, Yang, Bo Ram, Kim, Mi-Sook, Hwang, Yunji, Choi, Sung Hee
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 11.01.2020; BioMed Central; BMC
• Subjects: Acute coronary syndrome; Acute Coronary Syndrome - blood; Acute Coronary Syndrome - pathology; Acute coronary syndromes; Aged; Antilipemic agents; Arteriosclerosis; Atherosclerosis; Atherosclerosis - blood; Atherosclerosis - pathology; Cardiac patients; Cardiology; Cardiovascular agents; Cardiovascular disease; Cardiovascular diseases; Cardiovascular Diseases - blood; Cardiovascular Diseases - pathology; Care and treatment; Carotid arteries; Cholesterol; Cholesterol tests; Cholesterol, LDL - blood; Codes; Cohort analysis; Coronary artery disease; Coronary Disease - blood; Coronary Disease - pathology; Coronary heart disease; Diabetes; Diabetes mellitus; Diabetes Mellitus - blood; Diabetes Mellitus - pathology; Diseases; Dyslipidaemia; Dyslipidemia; Dyslipidemias; Female; Health; Health aspects; Health screening; Heart diseases; Humans; LDL cholesterol; Lipoproteins; Low density lipoprotein; Low density lipoprotein cholesterol; Low density lipoproteins; Male; Medical screening; Metabolic disorders; Middle Aged; National health insurance; Patients; Peripheral Arterial Disease - blood; Peripheral Arterial Disease - pathology; Republic of Korea - epidemiology; Retrospective Studies; Risk Factors; Risk groups; Society; Statins; Statistics; Stroke; Stroke - blood; Stroke - pathology; Stroke patients; Vascular diseases; Republic of Korea; South Korea; Stroke; Diabetes mellitus; Low density lipoprotein cholesterol; Cardiovascular disease; Dyslipidaemia; Statin; Acute coronary syndrome
• ISSN: 1476-511X; 1476-511X
• DOI: 10.1186/s12944-019-1158-5

Real-world evidence of low-density lipoprotein cholesterol (LDL-C) goal attainment rates for Asian patients is deficient. The objective of this study was to assess the status of dyslipidemia management, especially in high-risk patients with cardiovascular disease (CVD) including stroke and acute coronary syndrome (ACS). This was a retrospective cohort study of 514,866 subjects from the National Health Insurance Service-National Health Screening Cohort database in Korea. Participants were followed up from 2002 to 2015. Subjects with a high-risk of CVD prior to LDL-C measurement and subjects who were newly-diagnosed for high-risk of CVD following LDL-C measurement were defined as known high-risk patients (n = 224,837) and newly defined high-risk patients (n = 127,559), respectively. Data were analyzed by disease status: stroke, ACS, coronary heart disease (CHD), peripheral artery disease (PAD), diabetes mellitus (DM) and atherosclerotic artery disease (AAD). Overall, less than 50% of patients in each disease category achieved LDL-C goals (LDL-C < 70 mg/dL in patients with stroke, ACS, CHD and PAD; and LDL-C < 100 mg/dL in patients with DM and AAD). Statin use was observed in relatively low proportions of subjects (21.5% [known high-risk], 34.4% [newly defined high-risk]). LDL-C goal attainment from 2009 to 2015 steadily increased but the goal-achiever proportion of newly defined high-risk patients with ACS remained reasonably constant (38.7% in 2009; 38.1% in 2015). LDL-C goal attainment rates in high-risk patients with CVD and DM in Korea demonstrate unmet medical needs. Proactive management is necessary to bridge the gap between the recommendations of clinical guidelines and actual clinical practice.