Compliance with Lipid-Lowering Therapy Use and Achieving LDL-Cholesterol Target Levels in Patients with Coronary Artery Disease in The Cardiology Clinic of Kayseri City Hospital

Abstract

Introduction: Atherosclerotic heart disease is the leading cause of morbidity and mortality worldwide.When we look at the pathogenesis of atherosclerosis, dyslipidemias are one of the most common and correctable risk factor. In this study, we aimed to investigate lipid-lowering drug therapies and lipid levels in patients who needed lipid-lowering therapy due to coronary artery disease in cardiology clinic.

Method: Patients who were previously documented with coronary artery disease by coronary angiography between December 2018 and July 2019 were examined for lipid-lowering therapy.

Result: Total cholesterol and LDL-cholesterol levels were significantly lower in the lipid lowering group (198.1±40.4 ve 171.6±35.1, p≤0.001, 118,69±36.4 ve 92.2±31.5, p≤0.001, respectively). When we analyzed patients reaching LDL-cholesterol<55 mg / dL target value, one patient in the non-lipid lowering group achieved the target, while 20 patients in the lipid lowering group achieved the target (p=0.023).

Conclusion: In our study, it was found that the patients who were in a very high risk group due to coronary artery disease and who needed lipid-lowering treatment for secondary prevention did not use effective doses of medication.[o1]  The number of patients achieving LDL-cholesterol target was low in patients receiving lipid lowering therapy regardless of the dose used.

---

Keywords

• Coronary artery disease,Lipid-lowering treatment

Kayseri Şehir Hastanesi Kardiyoloji Kliniğinde Koroner Arter Hastalığı Olan Hastalarda Lipid Düşürücü İlaç Kullanımına Uyum ve LDL-Kolesterol Hedefine Ulaşma Düzeyleri

Abstract

Giriş: Aterosklerotik kalp hastalıkları tüm dünyada önde gelen morbidite ve mortalite nedenidir. Aterosklerozun patogenezine bakıldığında, dislipidemiler en yaygın ve düzeltilebilen risk faktörlerinden biridir. Bu çalışmamızda kardiyoloji kliniğinde takip etmekte olduğumuz koroner arter hastalığı nedeniyle lipid düşürücü tedavi alması gereken hastaların lipid düşürücü ilaç tedavileri ve lipid düzeylerinin incelenmesi amaçlanmıştır.

Yöntem: Aralık 2018 ile Temmuz 2019 arasında kardiyoloji kliniğine başvuran daha önce koroner anjiografi ile koroner arter hastalığı dökümante edilmiş hastalar lipid düşürücü ilaç tedavileri yönünden incelendi.

Bulgular: Lipid düşürücü ilaç kullanan grupta total kolesterol ve LDL-kolesterol seviyelerinin anlamlı olarak düşük olduğu tespit edildi (sırasıyla 198.1±40.4 ve 171.6±35.1, p≤0.001, 118,69±36.4 ve 92.2±31.5, p≤0.001). LDL-kolesterol<55 mg/dL hedef değerine ulaşan hastaları incelediğimizde, lipid düşürücü ilaç kullanmayan grupta bir hastada hedefe ulaşılırken, lipid düşürücü tedavi alan grupta 20 hastanın hedefe ulaştığı gözlendi (p=0.023).

Sonuç: Çalışmamızda koroner arter hastalığı nedeniyle çok yüksek risk grubunda olan ve ikincil koruma amaçlı lipid düşürücü tedavi alması gereken hastaların etkin dozda ilaç kullanmadıkları tespit edildi. Lipid düşürücü tedavi alan hastalarda kullanılan dozdan bağımsız olarak LDL-kolesterol hedefine ulaşan hasta sayısı düşük bulunmuştur.

Keywords

• Koroner arter hastalığı,Lipid düşürücü tedavi

References

1. 1. Townsend N, et al. Cardiovascular disease in Europe--epidemiological update 2015. Eur Heart J 2015;36:2696-705.
2. 2. Mahley RW, et al. Turkish Heart Study: lipids, lipoproteins, and apolipoproteins. J Lipid Res 1995;36:839-59.
3. 3. Kozan Ö, et al. Prevalence of the metabolic syndrome among Turkish adults. Eur J Clin Nutr 2007;61:548-53.
4. 4. Onat A. Lipids, lipoproteins and apolipoproteins among turks, and impact on coronary heart disease. Anadolu Kardiyol Derg 2004;4:236-45.
5. 5. Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive Summary of The Third Report of The National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, And Treatment of High Blood Cholesterol In Adults (Adult Treatment Panel III). JAMA 2001;285:2486-97.
6. 6. Authors/Task Force Members; ESC Committee for Practice Guidelines (CPG); ESC National Cardiac Societies. 2019 ESC/EAS guidelines for the management of dyslipidaemias: Lipid modification to reduce cardiovascular risk. Atherosclerosis 2019;290:140-205.
7. 7. Kotseva K, et al; EUROASPIRE II Study Group. Treatment potential for cholesterol management in patients with coronary heart disease in 15 European countries: findings from the EUROASPIRE II survey. Atherosclerosis 2008;197:710-7.
8. 8. Kotseva K, et al. EUROASPIRE III: a survey on the lifestyle, risk factors and use of cardioprotective drug therapies in coronary patients from 22 European countries. Eur J Cardiovasc Prev Rehabil 2009;16:121-37.

9. 9. Sahin O, et al. Bilirubin levels and the burden of coronary atherosclerosis in patients with STEMI. Angiology 2013 Apr;64(3):200-4.
10. 10. Tabas I, Williams KJ, Boren J. Subendothelial lipoprotein retention as the initiating process in atherosclerosis: update and therapeutic implications. Circulation 2007;116:1832-1844.
11. 11. Ference BA, et al. Impact of lipids on cardiovascular health: JACC Health Promotion Series. J Am Coll Cardiol 2018;72:1141- 1156.
12. 12. Baigent C, et al; Cholesterol Treatment Trialists’ (CTT) Collaborators. Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet 2005;366:1267-1278.
13. 13. Oesterle A, Laufs U, Liao JK. Pleiotropic effects of statins on the cardiovascular system. Circ Res 2017;120:229-243.
14. 14. Kültürsay H. Results of the rosuvastatin studies in Turkey. Türk Kardiyol Dern Arş 2007;35:24-30.
15. 15. Centers for Disease Control and Prevention (CDC). Vital signs: prevalence, treatment, and control of high levels of low-density lipoprotein cholesterol--United States, 1999-2002 and 2005-200. MMWR Morb Mortal Wkly Rep 2011;60:109-14.
16. 16. Yiğiner O, et al. Adherence to statin therapy and LDL cholesterol goal attainment in type 2 diabetics and secondary prevention patients: the role of education and knowledge. Turk Kardiyol Dern Ars 2010;38:544-50.
17. 17. Graham I, et al. European Society of Cardiology (ESC) Committee for Practice Guidelines (CPG). European guidelines on cardiovascular disease prevention in clinical practice: executive summary: Fourth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J 2007;28:2375-414.
18. 18. Çürük GN, Bayındır S, Oğuzhan A. Kardiyovasküler hastalığı olan hasta ve hasta yakınlarında kardiyovasküler hastalıklar risk faktörleri bilgi düzeyi ve sağlıklı yaşam biçimi davranışları. Sağlık Bilimleri Dergisi 2018; 27: 40-47.
19. 19. Ozkan B, et al. Awareness of Pleiotropic and Cardioprotective Effect of Statins in Patients with Coronary Artery Disease. Biomed Res Int 2018;2018:8961690.