Prevalence of dyslipidaemia in patients treated with lipid-lowering agents in China: Results of the DYSlipidemia International Study (DYSIS)

• Published in: Atherosclerosis 2014-08, Vol.235 (2), p.463-469
• Main Authors: Zhao, Shuiping, Wang, Yongjun, Mu, Yiming, Yu, Bilian, Ye, Ping, Yan, Xiaowei, Li, Zhanquan, Wei, Yidong, Ambegaonakr, Baishaili M, Hu, Dayi
• Format: Article
• Language: English
• Subjects: Aged; Cardiovascular; Cardiovascular diseases; Cardiovascular Diseases - epidemiology; China - epidemiology; Cholesterol, LDL - blood; Cross-Sectional Studies; Dyslipidaemia; Dyslipidemias - drug therapy; Dyslipidemias - epidemiology; Humans; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use; Hypolipidemic Agents - therapeutic use; LDL cholesterol; Lipid-lowering agents; Lipoproteins, HDL - blood; Middle Aged; Non-HDL cholesterol; Prevalence; Statin; Triglycerides - blood
• ISSN: 0021-9150; 1879-1484
• DOI: 10.1016/j.atherosclerosis.2014.05.916

Abstract Background Despite clear guideline recommendations, there is a paucity of data regarding the prevalence and type of persistent lipid profile abnormalities in patients on stable lipid-lowering therapy in China. Methods This cross-sectional trial included 25,697 patients treated with lipid-lowering agents from 122 centres between April 2012 and October 2012; all underwent clinical examination and had their latest fasting lipid profiles while on lipid-lowering therapy recorded. Logistic regression was performed to assess predictors for lipid abnormalities classified according to current Chinese guidelines. Findings Overall, 29.1% of patients had no lipid abnormalities, and 38.5% of patients did not achieve the therapeutic goal for low-density lipoprotein cholesterol (LDL-C), either as a single lipid anomaly or associated with low high-density lipoprotein cholesterol (HDL-C), elevated triglycerides, or both. Subjects with low risk were more likely than those with very high and high risk to be at target LDL-C levels. Furthermore, 10.4% of very high-risk patients and 11.1% of high-risk patients who attained the LDL-C goal failed to attain non-HDL-C goals. Diabetes was shown to be a strong predictor of failure in attaining non-HDL-C and both goals (OR 3.03; 3.22, 95% CI 2.58–3.55; 2.73–3.79, respectively). Conclusion Although great improvements have been made over the past decade, the large majority of very high-risk and high-risk patients treated with lipid-lowing agents still had one or more manifestations of dyslipidaemia. Further clinical evidence is needed to clarify whether adding other lipid-lowering agents to a statin will be associated with additional cardiovascular risk reduction.