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Int J Clin Pharm ; 39(4): 919-926, 2017 Aug.
Article in English | MEDLINE | ID: mdl-28523462

ABSTRACT

Background Current guidelines recommend a low-density lipoprotein cholesterol goal of <1.8 mmol/L (<70 mg/dL) and a non high-density lipoprotein cholesterol (non-HDL-C) goal of <2.6 mmol/L (<00 mg/dL) for coronary artery disease (CAD) patients. Objective This study aimed to describe real-life statin prescription strategies and to assess their effectiveness in terms of LDL-C and non-HDL-C goals attainment in a cohort of CAD patients. Setting Outpatient cardiology specialty clinics located in main Lebanese cities. Methods This is a retrospective crosssectional study. Eligible patients were those who had established CAD, treated with statins and having complete follow-up lipid panel at least 3 months from statin prescription. The following statin prescription strategies were considered in data analysis: prescription of different intensity statin as monotherapy, prescription of a statin in combination with: a low fat diet, another lipid-altering agent and another lipidaltering agent plus a low fat diet. Main outcome measure LDL-C goal attainment for each of the statin prescription strategy. Results Of the 423 CAD statin-treated patients, only 38.5 and 36.6% attained their recommended LDL-C and non-HDL-C goals, respectively. Using a statin in combination with ezetimibe or with another lipid-altering agent plus a low fat diet were significantly associated with LDL-C and non-HDL-C goals attainment. Conclusion Improvement of statin prescription strategies, such as using regular and scheduled dosage of high-intensity statins and combining statin therapy with ezetimibe, is therefore required when managing patients with CAD.


Subject(s)
Anticholesteremic Agents/administration & dosage , Cholesterol, HDL/blood , Cholesterol, LDL/blood , Coronary Artery Disease/blood , Coronary Artery Disease/drug therapy , Hydroxymethylglutaryl-CoA Reductase Inhibitors/administration & dosage , Aged , Cholesterol, HDL/antagonists & inhibitors , Cholesterol, LDL/antagonists & inhibitors , Coronary Artery Disease/epidemiology , Cross-Sectional Studies , Diet, Fat-Restricted/trends , Drug Prescriptions , Drug Therapy, Combination , Female , Goals , Humans , Lebanon/epidemiology , Male , Middle Aged , Retrospective Studies
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