Clinical characteristics and management of hyperlipoproteinemia in patients with chronic coronary heart disease in Slovakia
IntroductionA reduction of LDL-cholesterol is beneficial for high-risk patients, including patients with previously documented coronary heart disease (CHD). Data on the overall composition, risk profile, and management of these patients is very limited in Slovakia.Material and methodsThis cross-sectional multicentre observational study was conducted by cardiologists and internists providing outpatient care at 35 sites across Slovakia between 11/2015 and 01/2016. All patients had documented CHD and fulfilled the very high CV risk criteria (ESC recommendations).ResultsA total of 349 patients were recruited, had a mean age of 67.8 years, 67.9% were male, 41% had diabetes and a mean BMI of 29.5 kg/m2. As many as 65.3% had prior myocardial infarction, 59.2% underwent PCI, and 24.1% CABG. At baseline 90.5% of patients reported taking a statin, 10.3% ezetimibe and 5.4% a fibrate. The mean LDL-C level was 2.69±1.02 mmol/L with only 18.6% meeting their treatment target of <1.8 mmol/L. Mean values for TC (4.44mmol/L), HDL-C (1.20 mmol/L, and triglycerides (1.68 mmol/L) were within normal limits. A higher age (aOR 3.40; 95%CI 1.77-6.53) and the use of more than 20 mg per day atorvastatin equivalent dose of a statin (aOR 2.20; 95%CI 1.13-4.28) were associated with treatment target achievement in a multivariable adjusted model while female gender conferring a reduced likelihood (aOR 0.48; 95%CI 0.24-0.99).ConclusionsPatients at high cardiovascular risk in Slovakia are far off the <1.8 mmol/L LDL-C level recommended for the protection from adverse events and achieve their treatment targets less often (18.6%) than in the mean of other countries globally (29.4%).