Many statin-treated patients are not achieving treatment goals and are at risk of cardiovascular (CV) disease. We report the results of patients enrolled in an observational study in Greece, which estimated the residual lipid abnormalities in statin-treated patients. Low-density lipoprotein cholesterol (LDL-c), high-density lipoprotein cholesterol (HDL-c), and triglyceride concentrations were recorded in patients receiving statin therapy for ≥3 months, classified by CV risk according to European Society of Cardiology guidelines. Sixty-three percent of statin-treated patients had an LDL-c not at goal. Low-risk patients were more likely to have an LDL-c not at goal compared with high-risk patients (67.3% vs 61.0%, respectively). They were also less likely to have low HDL-c levels and elevated triglyceride levels compared with high-risk patients. Smoking and sedentary lifestyle were not associated with dyslipidemia in this population. Approximately two thirds of statin-treated patients in Greece are not reaching target/normal lipid levels and could benefit from improved lipid management.
GrahamIAtarDBorch-JohnsenK. European guidelines on cardiovascular disease prevention in clinical practice: full text. Fourth Joint Task Force of the European Society of Cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Eur J Cardiovasc Prev Rehabil. 2007;14(suppl 2):S1–S113.
ChimonasTFanourakiILiberopoulosENChimonasEElisafM.Diverging trends in cardiovascular morbidity and mortality in a low risk population. Eur J Epidemiol. 2009;24(8):415–423.
4.
LealJLuengo-FernandezRGrayAPetersenSRaynerM.Economic burden of cardiovascular diseases in the enlarged European Union. Eur Heart J. 2006;27(13):1610–1619.
5.
NissenSETuzcuEMSchoenhagenP. Effect of intensive compared with moderate lipid-lowering therapy on progression of coronary atherosclerosis: a randomized controlled trial. JAMA. 2004;291(9):1071–1080.
6.
NissenSENichollsSJSipahiI. Effect of very high-intensity statin therapy on regression of coronary atherosclerosis: the ASTEROID trial. JAMA. 2006;295(13):1556–1565.
7.
KotsevaKWoodDDe BackerGde BacquerDPyoralaKKeilU.Cardiovascular prevention guidelines in daily practice: a comparison of EUROASPIRE I, II, and III surveys in eight European countries. Lancet. 2009;373(9667):929–940.
8.
KotsevaKWoodDDe BackerG. EUROASPIRE III. Management of cardiovascular risk factors in asymptomatic high-risk patients in general practice: cross-sectional survey in 12 European countries. Eur J Cardiovasc Prev Rehabil. 2010;17(5):530–540.
9.
KotsevaKStagmoMde BacquerDDe BackerGWoodD.Treatment potential for cholesterol management in patients with coronary heart disease in 15 European countries: findings from the EUROASPIRE II study. Atherosclerosis. 2008;197(2):710–717.
10.
BarterPGottoAMLaRosaJC. HDL cholesterol, very low levels of LDL cholesterol, and cardiovascular events. N Engl J Med. 2007;357(13):1301–1310.
Ministry of Health and Welfare: Supreme Scientific Health Council. .Dietary guidelines for adults in Greece. Arch Hel Med. 1999;16(5):516–524.
13.
MaronDJFazioSLintonMF.Current perspectives on statins. Circulation. 2000;101(2):207–213.
14.
RobertsWC.The rule of 5 and the rule of 7 in lipid-lowering by statin drugs. Am J Cardiol. 1997;80(1):106–107.
15.
MigdalisIEfthimiadisAPappasSAlexopoulosDVlasserouFMikhailidisDP.Clinical experience with ezetimibe/simvastatin in a Mediterranean population. Curr Med Res Opin. 2009;25(10):2571–2576.
16.
HatzitoliosAIAthyrosVGKaragiannisAIMPROVE Collaborative Group. .Implementation of strategy for the management of overt dyslipidemia: the IMPROVE-dyslipidemia study. Int J Cardiol. 2009;134(3):322–329.
17.
GittADrexelHFeelyJ. Persistent lipid abnormalities in statin-treated patients and predictors of LDL-cholesterol goal achievement in clinical practice in Europe and Canada. Eur J Cardiovasc Prev Rehabil. 2011Mar 10. [Epub ahead of print].
18.
GoodmanSGLangerABastienNR. Prevalence of dyslipidemia in statin-treated patients in Canada: results of the DYSlipidemia International Study (DYSIS). Can J Cardiol. 2010;26(9):e331–e335.
19.
ElisafMSNikasN.Centralized Pan-European survey on the undertreatment of hypercholesterolemia in patients using lipid lowering drugs-the CEPHEUS-Greece survey. Angiology. 2010;61(5):465–474.
20.
LiberopoulosENElisafMS.Control of cardiovascular risk factors in outpatients with atherothrombosis in Greece. Atherosclerosis Suppl. 2007;8(5):130–131.
21.
JafriHAlsheikh-AliAAKarasRH.Meta-analysis: statin therapy does not alter the association between low levels of high-density lipoprotein cholesterol and increased cardiovascular risk. Ann Intern Med. 2010;153(12):800–808.
22.
FaergemanOHolmeIFayyadRSteering Committees of IDEAL and TNT Trials. .Plasma triglycerides and cardiovascular events in the Treating to New Targets and Incremental Decrease in End-Points through Aggressive Lipid Lowering trials of statins in patients with coronary artery disease. Am J Cardiol. 2009;104(4):459–463.
23.
HermansMPCastro CabezasMStrandbergT. Centralized Pan-European survey on the under-treatment of hypercholesterolaemia (CEPHEUS): overall findings from eight countries. Curr Med Res Opin. 2010;26(2):445–454.
24.
BhattDLStegPGOhmanEMREACH Registry Investigators. .International prevalence, recognition, and treatment of cardiovascular risk factors in outpatients with atherothrombosis. JAMA. 2006;295(2):180–189.
25.
BourgaultCDavignonJFodorG. Statin therapy in Canadian patients with hypercholesterolemia: The Canadian Lipid Study-Observational (CALIPSO). Can J Cardiol. 2005;21(13):1187–1193.
26.
GoffDCBertoniAGKramerH. Dyslipidemia prevalence, treatment, and control in the Multi-Ethnic Study of Atherosclerosis (MESA): gender, ethnicity, and coronary artery calcium. Circulation. 2006;113(5):647–656.
27.
LaironD.Intervention studies on Mediterranean diet and cardiovascular risk. Mol Nutr Food Res. 2007;51(10):1209–1214.
28.
VardavasCILinardakisMKHatzisCMSarisWHKafatosHG.Cardiovascular disease risk factors and dietary habits of farmers from Crete 45 years after the first description of the Mediterranean diet. Eur J Cardiovasc Prev Rehabil. 2010;17(4):440–446.
29.
PanagiotakosDBPitsavosCChrysohoouCSkoumasJStefanadisC.Status and management of blood lipids in Greek adults and their relation to socio-demographic, lifestyle and dietary factors: the ATTICA Study. Blood lipids distribution in Greece. Atherosclerosis. 2004;173(2):353–361.
30.
KrobotKJYinDDAlemaoESteinhagen-ThiessenE.Real-world effectiveness of lipid-lowering therapy in male and female outpatients with coronary heart disease: relation to pre-treatment low-density lipoprotein-cholesterol, pre-treatment coronary heart disease risk, and other factors. Eur J Cardiovasc Prev Rehabil. 2005;12(1):37–45.
31.
PetrettaMCostanzoPPerrone-FilardiPChiarielloM.Impact of gender in primary prevention of coronary heart disease with statin therapy: a meta-analysis. Int J Cardiol. 2010;138(1):25–31.
32.
MoraSGlynnRJHsiaJMacFadyenJGGenestJRidkerPM.Statins for the primary prevention of cardiovascular events in women with elevated high-sensitivity C-reactive protein or dyslipidemia: results from the Justification for the Use of Statins in Prevention: An Intervention Trial Evaluating Rosuvastatin (JUPITER) and meta-analysis of women from primary prevention trials. Circulation. 2010;121(9):1069–1077.
33.
LiberopoulosENMikhailidisDPElisafMS.Diagnosis and management of the metabolic syndrome in obesity. Obes Rev. 2005;6(4):283–296.
