Achievement of low density lipoprotein cholesterol targets in 18 countries outside Western Europe: International Study of Cholesterol Management Practices (ICLPS)

Argentine subanalysis

Abstract

Little is known about the achievement of low-density lipoprotein cholesterol targets in patients in cardiovascular risk receiving stable lipid-lowering therapy in countries outside Western Europe. Methods: This cross-sectional observational study was conducted since August 2015 to August 2016 in 18 countries outside Western Europe, including Argentina. Patients (n = 9049) treated for >3 months with lipid lowering therapy and in whom an LDL-C measurement was available within the previous 12 months were included. In this paper we report results from Argentine patients. Results: Argentina enrolled 307 patients. The mean +SD age was 63.7 +12.1 years, 59.6% of patients were men and the mean +SD LDL-C value on therapy was 96.3 +36.7 mg/dl. At enrolment, 97.4% of patients were receiving a statin (23.1% on high-intensity treatment), and 14.7 % were receiving the highest dose available. The SCORE scale was used to measure cardiovascular risk. In Very High Risk patients, the level of risk was diagnosed in only 39.1% of patients. The target for Very High Risk (LDL-C <70 mg/dl) was achieved in 27.8% of patients in this group; the target for High Risk (LDL-C <100 mg/dl) was achieved in 55.9 % of patients in this group. Statin intolerance was reported in <10% of patients. Conclusions: This study shows a low percentage of patients reaching the goals, together with a low percentage of use of high-intensity statins. The low use of high-intensity statins is not justified by the low percentage (<10%) of patients with some intolerance to statins. The percentage of accuracy in the diagnosis of risk in these patients is also low. Both the inaccuracy to detect the Very High or the High Risk, and the low success rate to reach objectives can be corrected, at least in part, with continuous education for physicians and patients.