Do We Achieve Target Lipid Levels with Statins in Patients with Coronary Artery Disease?

Abstract

Background: Lowering LDL cholesterol with statins is an established strategy for secondary prevention of coronary artery disease (CAD). However, many patients fail to achieve recommended lipid targets in routine clinical practice.

Objectives: To determine the proportion of patients with CAD achieving target lipid levels after statin therapy.

Methods: A retrospective analysis of 852 patients with established coronary artery disease attending a lipid clinic was performed. Baseline lipid values before statin initiation were available for 446 patients. Lipid profiles before treatment and at follow-up were compared, and achievement of National Cholesterol Education Program (NCEP ATP III) lipid goals was assessed.

Results:

• Mean LDL cholesterol decreased from 171.3 mg/dL to 105.1 mg/dL.
• Only 42.2% of patients achieved the LDL-C goal of <100 mg/dL.
• 59.1% achieved HDL cholesterol >40 mg/dL.
• 81% achieved triglyceride levels <150 mg/dL.

Conclusion: Despite statin therapy, the majority of CAD patients did not achieve recommended LDL cholesterol targets. The authors recommend more aggressive lipid-lowering strategies, including use of more potent statins, addition of ezetimibe when required, physician-driven dose optimization, and lifestyle modification to improve goal attainment.