[Lipid lowering after percutaneous coronary intervention. Intended and achieved treatment goals in real life]

Abstract

Background: Dyslipidemia is associated with development and progression of coronary artery disease. Especially patients after coronary revascularization benefit by treatment with lipid-lowering drugs. Guidelines for lipid-lowering therapy in patients with or without coronary artery disease recommend treatment goals of lipid levels. However, relevant discrepancies between evidence-based goals and achieved lipid levels in "real life" are reported in large studies.

Methods and results: In this study the dynamics of lipid levels (total cholesterol, LDL cholesterol, HDL cholesterol, triglycerides) and of lipid-lowering drugs were analyzed over a 5.5-month period in patients undergoing percutaneous coronary intervention. At the time of coronary intervention only 49.8% of patients were on lipid-lowering drugs, during follow-up dosage was modified only in exceptional cases. Although 87.5% of patients were treated at the time of follow-up, guideline-oriented lipid levels were achieved only in 32.5% of patients after 5.5 months.

Conclusion: In a high-risk patient population after coronary revascularization, an ineffective treatment of hypercholesterolemia was found. A major problem is the lack of dosage modification of lipid-lowering drugs after initiation. By closer cooperation between hospital and general practitioner lipid-lowering treatment will be optimized and the rate of cardiovascular events will be decreased over long-term follow-up.