Low-Density Lipoprotein Cholesterol Targets in Patients With Coronary Heart Disease in Extremadura (Spain): LYNX Registry

Jose Javier Gomez-Barrado, Paula Gomez-Turegano, Carolina Ortiz-Cortes, Jorge Vega-Fernandez, Marta Gomez-Turegano, Francisco Javier Garciperez de Vargas, Luis Enrique Lezcano Gort, Zineb Kounka, Benjamin Roque Rodriguez, David Chipayo Gonzales, Paloma Perez-Espejo, Ana Isabel Fernandez-Chamorro, Maria Beltran Moreno, Maria Jose Romero Castro, Maria Victoria Mogollon Jimenez, Gonzalo Marcos Gomez, Yolanda Porras Ramos

Abstract


Background: Low-density lipoprotein cholesterol (LDL-C) contributes decisively to the development of cardiovascular disease (CVD). In the LYNX registry we determined the rate of achievement of the target value of LDL-C, the use of lipid-lowering therapy (LLT) and the predictive factors of not reaching the target in patients with stable coronary heart disease (CHD).

Methods: LYNX included consecutive patients with stable CHD treated at the University Hospital of Caceres, Extremadura (Spain) from September 2016 to September 2018, and those who must have an LDL-C target below 70 mg/dL according to the European Society of Cardiology (ESC) 2016 guidelines. The variables independently associated with the breach of the LDL-C objective were evaluated by multivariable logistic regression.

Results: A total of 674 patients with stable CHD were included. The average LDL-C levels were 68.3 ± 24.5 mg/dL, with 56.7% showing a level below 70 mg/dL. LLT was used by 96.7% of patients, 71.7% were treated with high-powered statins and 30.1% with ezetimibe. The risk of not reaching the target value of LDL-C was higher in women, in active smokers, and in those who had multivessel CHD or had atrial fibrillation. Patients with diabetes mellitus, those who took potent statins or co-administration treatment with ezetimibe were more likely to reach the target level of LDL-C.

Conclusions: The treatment of dyslipidemia in patients with chronic CHD remains suboptimal; however, an increasing number of very high-risk patients achieve the LDL-C objective, although there is still enormous potential to improve cardiovascular outcome through the use of more intensive LLT.




Cardiol Res. 2020;11(5):311-318
doi: https://doi.org/10.14740/cr1079

Keywords


Coronary heart disease; Dyslipidemia; Statin; LDL-C; Spain

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