Clinical characteristics and management of hyperlipoproteinemia in patients with chronic coronary heart disease in Slovakia

Introduction: A reduction of low-density lipoprotein (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 are very limited in Slovakia. Material and methods: This cross-sectional multicenter 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 cardiovascular (CV) risk criteria (ESC recommendations). Results: . As many as 65.3% had prior myocardial infarction, 59.2% underwent percutaneous coronary intervention, and 24.1% coronary artery bypass grafting. 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 total cholesterol (4.44 mmol/l), high-density lipoprotein cholesterol (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/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 conferred a reduced likelihood (aOR = 0.48; 95% CI: 0.24-0.99). Conclusions: Patients at high cardiovascular risk in Slovakia are far off the < 1.8 mmol/l LDL-C level recommended for protection from adverse events, and a lower percentage achieve their treatment targets (18.6%) than the mean of other countries globally (29.4%).