Published Online
on June 22, 2009

A more recent version of this article appeared on July 7, 2009

This Article Full Text (PDF) CME: Take the course for this article: Circulation: July 7, 2009, Volume 120, Number 1 All Versions of this Article: 120/1/28    most recent CIRCULATIONAHA.108.838466v1 Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Google Scholar Articles by Waters, D. D. PubMed PubMed Citation Articles by Waters, D. D. Pubmed/NCBI databases Substance via MeSH Medline Plus Health Information Cholesterol Statins Related Collections Lipids Related Articles

Submitted on December 1, 2008
Accepted on April 10, 2009

Lipid Treatment Assessment Project 2. A Multinational Survey to Evaluate the Proportion of Patients Achieving Low-Density Lipoprotein Cholesterol Goals

David D. Waters MD^*, Carlos Brotons MD, Cheng-Wen Chiang MD, Jean Ferrières MD, JoAnne Foody MD, J. Wouter Jukema MD, Raul D. Santos MD, Juan Verdejo MD, Michael Messig PhD, Ruth McPherson MD, Ki-Bae Seung MD, Lisa Tarasenko PharmD, for the Lipid Treatment Assessment Project 2 Investigators

From the Division of Cardiology, San Francisco General Hospital and the University of California, San Francisco (D.D.W.); Sardenya Primary Care Center, Barcelona, Spain (C.B.); Cathay General Hospital and Taipei Medical University, Taipei, Taiwan (C.-W.C.); Department of Cardiology, Toulouse University School of Medicine, Rangueil Hospital, Toulouse, France (J.F.); Division of Cardiovascular Medicine, Department of Internal Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Mass (J.F.); Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands (J.W.J.); the Lipid Clinic Heart Institute (InCor), University of São Paulo Hospital, São Paulo, Brazil (R.D.S.); National Institute of Cardiology "Ignacio Chávez," Tlalpan, Mexico (J.V.); Pfizer Inc., New York, NY (M.M., L.T.); Lipid Research Laboratory, University of Ottawa Heart Institute, Ottawa, Canada (R.M.); and Department of Internal Medicine, Kangnam St Mary's Hospital, Catholic University of Korea, Seoul, Korea (K.-B.S.).

^* To whom correspondence should be addressed. E-mail: dwaters{at}medsfgh.ucsf.edu.

Background—Information about physicians' adherence to cholesterol management guidelines remains scant. The present survey updates our knowledge of lipid management worldwide.

Methods and Results—Lipid levels were determined at enrollment in dyslipidemic adult patients on stable lipid-lowering therapy in 9 countries. The primary end point was the success rate, defined as the proportion of patients achieving appropriate low-density lipoprotein cholesterol (LDL-C) goals for their given risk. The mean age of the 9955 evaluable patients was 62±12 years; 54% were male. Coronary disease and diabetes mellitus had been diagnosed in 30% and 31%, respectively, and 14% were current smokers. Current treatment consisted of a statin in 75%. The proportion of patients achieving LDL-C goals according to relevant national guidelines ranged from 47% to 84% across countries. In low-, moderate-, and high-risk groups, mean LDL-C was 119, 109, and 91 mg/dL and mean high-density lipoprotein cholesterol was 62, 49, and 50 mg/dL, respectively. The success rate for LDL-C goal achievement was 86% in low-, 74% in moderate-, and 67% in high-risk patients (73% overall). However, among coronary heart disease patients with 2 risk factors, only 30% attained the optional LDL-C goal of <70 mg/dL. In the entire cohort, high-density lipoprotein cholesterol was <40 mg/dL in 19%, 40 to 60 mg/dL in 55%, and >60 mg/dL in 26% of patients.

Conclusions—Although there is room for improvement, particularly in very-high-risk patients, these results indicate that lipid-lowering therapy is being applied much more successfully than it was a decade ago.

Key words: hypercholesterolemia • lipids • prevention • statins

Related Articles:

Circulation: Clinical Summaries
Circulation 2009 120: 1-2. [Extract] [Full Text]

Improving Lipid Goal Attainment: Is It Enough?

Antonio M. Gotto, Jr
Circulation 2009 120: 3-5. [Extract] [Full Text]

This article has been cited by other articles:

				A. M. Gotto Jr Improving Lipid Goal Attainment: Is It Enough? Circulation, July 7, 2009; 120(1): 3 - 5. [Full Text] [PDF]