Ten centers' study on the present state of treatment for hypercholesterolemia in patients with coronary artery disease / 대한내과학회지

ABSTRACT

BACKGROUND: Previous studies showed 'treatment gap' phenomenon in the treatment of hyperlipidemia, meaning failure to adhere to the recommendation in the treatment guideline. In Korea, systematic research on this issue has never been done. This investigation was to estimate the hypercholesterolemia treatment gap in coronary artery disease (CAD) patients in tertiary care centers according to NCEP ATP-III guideline. METHODS: Ten Korean educational hospital participated in the survey, reviewing medical record of 1,048 patients. Patients were enrolled when they were documented as having coronary artery disease by coronary angiography or stress tests or medical history of myocardial infarction, percutaneous coronary intervention or bypass surgery. Thirty or more medical records per each of 3 or more cardiologists were reviewed in each hospital. Sampling was done sequentially based on outpatient or inpatient list. Pharmacological treatment for hyperlipidemia included the first and last records of prescription. Baseline and the most recent lipid profiles were collected. RESULTS: Findings from the survey was summarized as '10 to 50% rule' 10% mean LDL-cholesterol reduction without lipid-lowering drug, 20% LDL-cholesterol level at the treatment goal before any treatment, 30% mean LDL-cholesterol reduction with lipid-lowering drug treatment, 40% proportion of CAD patients without lipid-lowering drug, 50% treatment goal achievement after treatment. CONCLUSIONS: Significant treatment gap exists in Korean cardiology practice in tertiary care centers. Systematic approach to reduce this gap is warranted.