Frequency of Attainment of Low-Density Lipoprotein Cholesterol and Non–High-Density Lipoprotein Cholesterol Goals in Cardiovascular Clinical Practice (from the National Cardiovascular Data Registry PINNACLE Registry)
Studies have found that non–high-density lipoprotein cholesterol (non-HDL-C) is a superior marker for coronary heart disease compared to low-density lipoprotein cholesterol (LDL-C). Little is known about achievement of non-HDL-C goals outside clinical trials. Within a population of 146,064 patients...
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| Veröffentlicht in: | The American journal of cardiology 2015-08, Vol.116 (4), p.547-553 |
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| creator | Spinler, Sarah A., PharmD Cziraky, Mark J., PharmD Willey, Vincent J., PharmD Tang, Fengming, MS Maddox, Thomas M., MD, MSc Thomas, Tyan, PharmD Dueñas, Gladys G., PharmD Virani, Salim S., MD, PhD |
| description | Studies have found that non–high-density lipoprotein cholesterol (non-HDL-C) is a superior marker for coronary heart disease compared to low-density lipoprotein cholesterol (LDL-C). Little is known about achievement of non-HDL-C goals outside clinical trials. Within a population of 146,064 patients with dyslipidemia in the PINNACLE Registry and a subgroup of 36,188 patients with diabetes mellitus (DM), we examined the proportion of patients and patient characteristics associated with having LDL-C, non-HDL-C, and both LDL-C and non-HDL-C levels at National Cholesterol Education Program goals. LDL-C, non-HDL-C, and both LDL-C and non-HDL-C goals in the overall cohort were achieved by 73%, 73.4%, and 68.9% patients, respectively. Significant predictors of meeting all 3 goals were age, male gender, statin, nonstatin, and combined statin plus nonstatin use. Patients with co-morbidities of hypertension, previous stroke or transient ischemic attack, peripheral arterial disease, myocardial infarction, and smoking were less likely to have LDL-C, non-HDL-C, and both LDL-C and non-HDL-C levels at National Cholesterol Education Program goal. In the overall cohort, patients with DM were less likely to meet non-HDL-C and both LDL-C and non-HDL-C goals. In the subgroup of patients with DM, predictors of meeting lipid goals were similar to the overall cohort. In conclusion, these data suggest contemporary treatment patterns by cardiologists successfully achieve lipid goals in most patients. Younger, female patients and those with atherosclerotic cardiovascular disease and risk factors, such as hypertension and DM, are less likely to achieve goals and may require more careful follow-up after statin initiation. Both LDL-C and non-HDL-C goals are achieved in |
| doi_str_mv | 10.1016/j.amjcard.2015.05.011 |
| format | Article |
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Little is known about achievement of non-HDL-C goals outside clinical trials. Within a population of 146,064 patients with dyslipidemia in the PINNACLE Registry and a subgroup of 36,188 patients with diabetes mellitus (DM), we examined the proportion of patients and patient characteristics associated with having LDL-C, non-HDL-C, and both LDL-C and non-HDL-C levels at National Cholesterol Education Program goals. LDL-C, non-HDL-C, and both LDL-C and non-HDL-C goals in the overall cohort were achieved by 73%, 73.4%, and 68.9% patients, respectively. Significant predictors of meeting all 3 goals were age, male gender, statin, nonstatin, and combined statin plus nonstatin use. Patients with co-morbidities of hypertension, previous stroke or transient ischemic attack, peripheral arterial disease, myocardial infarction, and smoking were less likely to have LDL-C, non-HDL-C, and both LDL-C and non-HDL-C levels at National Cholesterol Education Program goal. In the overall cohort, patients with DM were less likely to meet non-HDL-C and both LDL-C and non-HDL-C goals. In the subgroup of patients with DM, predictors of meeting lipid goals were similar to the overall cohort. In conclusion, these data suggest contemporary treatment patterns by cardiologists successfully achieve lipid goals in most patients. Younger, female patients and those with atherosclerotic cardiovascular disease and risk factors, such as hypertension and DM, are less likely to achieve goals and may require more careful follow-up after statin initiation. Both LDL-C and non-HDL-C goals are achieved in <70% of patients, suggesting room for improvement if a goal-targeted individualized strategy is adopted.</description><identifier>ISSN: 0002-9149</identifier><identifier>EISSN: 1879-1913</identifier><identifier>DOI: 10.1016/j.amjcard.2015.05.011</identifier><identifier>PMID: 26089010</identifier><identifier>CODEN: AJCDAG</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Age Factors ; Aged ; Cardiology ; Cardiovascular ; Cardiovascular disease ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - prevention & control ; Cholesterol ; Cholesterol, HDL - blood ; Cholesterol, LDL - blood ; Cohort Studies ; Diabetes Complications - blood ; Diabetes Complications - complications ; Drug therapy ; Dyslipidemias - blood ; Dyslipidemias - complications ; Dyslipidemias - drug therapy ; Female ; Heart attacks ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use ; Low density lipoprotein ; Male ; Middle Aged ; Outcome Assessment (Health Care) ; Practice Guidelines as Topic ; Registries ; Sex Factors ; Statins ; United States - epidemiology</subject><ispartof>The American journal of cardiology, 2015-08, Vol.116 (4), p.547-553</ispartof><rights>Elsevier Inc.</rights><rights>2015 Elsevier Inc.</rights><rights>Copyright © 2015 Elsevier Inc. All rights reserved.</rights><rights>Copyright Elsevier Limited Aug 15, 2015</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c584t-ea4f5639122c03a272a519b1e94d92684db7dccab7816587c440c3a37d0c94143</citedby><cites>FETCH-LOGICAL-c584t-ea4f5639122c03a272a519b1e94d92684db7dccab7816587c440c3a37d0c94143</cites><orcidid>0000-0003-4552-0053</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0002914915013351$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26089010$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Spinler, Sarah A., PharmD</creatorcontrib><creatorcontrib>Cziraky, Mark J., PharmD</creatorcontrib><creatorcontrib>Willey, Vincent J., PharmD</creatorcontrib><creatorcontrib>Tang, Fengming, MS</creatorcontrib><creatorcontrib>Maddox, Thomas M., MD, MSc</creatorcontrib><creatorcontrib>Thomas, Tyan, PharmD</creatorcontrib><creatorcontrib>Dueñas, Gladys G., PharmD</creatorcontrib><creatorcontrib>Virani, Salim S., MD, PhD</creatorcontrib><creatorcontrib>NCDR</creatorcontrib><title>Frequency of Attainment of Low-Density Lipoprotein Cholesterol and Non–High-Density Lipoprotein Cholesterol Goals in Cardiovascular Clinical Practice (from the National Cardiovascular Data Registry PINNACLE Registry)</title><title>The American journal of cardiology</title><addtitle>Am J Cardiol</addtitle><description>Studies have found that non–high-density lipoprotein cholesterol (non-HDL-C) is a superior marker for coronary heart disease compared to low-density lipoprotein cholesterol (LDL-C). Little is known about achievement of non-HDL-C goals outside clinical trials. Within a population of 146,064 patients with dyslipidemia in the PINNACLE Registry and a subgroup of 36,188 patients with diabetes mellitus (DM), we examined the proportion of patients and patient characteristics associated with having LDL-C, non-HDL-C, and both LDL-C and non-HDL-C levels at National Cholesterol Education Program goals. LDL-C, non-HDL-C, and both LDL-C and non-HDL-C goals in the overall cohort were achieved by 73%, 73.4%, and 68.9% patients, respectively. Significant predictors of meeting all 3 goals were age, male gender, statin, nonstatin, and combined statin plus nonstatin use. Patients with co-morbidities of hypertension, previous stroke or transient ischemic attack, peripheral arterial disease, myocardial infarction, and smoking were less likely to have LDL-C, non-HDL-C, and both LDL-C and non-HDL-C levels at National Cholesterol Education Program goal. In the overall cohort, patients with DM were less likely to meet non-HDL-C and both LDL-C and non-HDL-C goals. In the subgroup of patients with DM, predictors of meeting lipid goals were similar to the overall cohort. In conclusion, these data suggest contemporary treatment patterns by cardiologists successfully achieve lipid goals in most patients. Younger, female patients and those with atherosclerotic cardiovascular disease and risk factors, such as hypertension and DM, are less likely to achieve goals and may require more careful follow-up after statin initiation. Both LDL-C and non-HDL-C goals are achieved in <70% of patients, suggesting room for improvement if a goal-targeted individualized strategy is adopted.</description><subject>Age Factors</subject><subject>Aged</subject><subject>Cardiology</subject><subject>Cardiovascular</subject><subject>Cardiovascular disease</subject><subject>Cardiovascular Diseases - epidemiology</subject><subject>Cardiovascular Diseases - prevention & control</subject><subject>Cholesterol</subject><subject>Cholesterol, HDL - blood</subject><subject>Cholesterol, LDL - blood</subject><subject>Cohort Studies</subject><subject>Diabetes Complications - blood</subject><subject>Diabetes Complications - complications</subject><subject>Drug therapy</subject><subject>Dyslipidemias - blood</subject><subject>Dyslipidemias - complications</subject><subject>Dyslipidemias - drug therapy</subject><subject>Female</subject><subject>Heart attacks</subject><subject>Humans</subject><subject>Hydroxymethylglutaryl-CoA Reductase Inhibitors - 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In the overall cohort, patients with DM were less likely to meet non-HDL-C and both LDL-C and non-HDL-C goals. In the subgroup of patients with DM, predictors of meeting lipid goals were similar to the overall cohort. In conclusion, these data suggest contemporary treatment patterns by cardiologists successfully achieve lipid goals in most patients. Younger, female patients and those with atherosclerotic cardiovascular disease and risk factors, such as hypertension and DM, are less likely to achieve goals and may require more careful follow-up after statin initiation. Both LDL-C and non-HDL-C goals are achieved in <70% of patients, suggesting room for improvement if a goal-targeted individualized strategy is adopted.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>26089010</pmid><doi>10.1016/j.amjcard.2015.05.011</doi><tpages>7</tpages><orcidid>https://orcid.org/0000-0003-4552-0053</orcidid></addata></record> |
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| ispartof | The American journal of cardiology, 2015-08, Vol.116 (4), p.547-553 |
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| source | MEDLINE; ScienceDirect Journals (5 years ago - present) |
| subjects | Age Factors Aged Cardiology Cardiovascular Cardiovascular disease Cardiovascular Diseases - epidemiology Cardiovascular Diseases - prevention & control Cholesterol Cholesterol, HDL - blood Cholesterol, LDL - blood Cohort Studies Diabetes Complications - blood Diabetes Complications - complications Drug therapy Dyslipidemias - blood Dyslipidemias - complications Dyslipidemias - drug therapy Female Heart attacks Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors - therapeutic use Low density lipoprotein Male Middle Aged Outcome Assessment (Health Care) Practice Guidelines as Topic Registries Sex Factors Statins United States - epidemiology |
| title | Frequency of Attainment of Low-Density Lipoprotein Cholesterol and Non–High-Density Lipoprotein Cholesterol Goals in Cardiovascular Clinical Practice (from the National Cardiovascular Data Registry PINNACLE Registry) |
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