The Achievement of Non-high-density Lipoprotein Cholesterol Target in Patients with Very High Atherosclerotic Cardiovascular Disease Risk Stratified by Triglyceride Levels Despite Statin-controlled Low-density Lipoprotein Cholesterol

Oman Medical Journal

Khamis Al-Hashmi¹  Shorook Al Herz²  Othman Metwally³  Fahad Omar Ahmed S. Baslaib⁴  Khalid Al-Waili⁵  Mohamed Arafah⁶  Khalid Al-Rasadi⁷  Ibrahim Al-Zakwani⁸  Wael Al Mahmeed⁹  Hilal Al-Sabti^1,10  Obaid Al Jassim^1,11  Omar Al Hallaq^1,11  Afzal Hussein Yusufali^1,11  Mahmoud Al Awadhi^1,12  Akram Alkhadra^1,13  Hossam Elghetany^1,14  Mohammed Fakhry^1,14  Faisal Al Anazi^1,15  Abdullah Shehab^1,16  Ali T. Al-Hinai^1,17  Khalid Al Nemer^1,18  Haitham Amin^1,19  Abdel Razak Medani^2,20  Omer Al Tamimi^2,21 

[1] Gulf Health Research, Muscat, Oman;Al Amiri Hospital, Kuwait City, Kuwait;Al-Imam Mohammad Ibn Saud Islamic University, School of Medicine, Riyadh, Saudi Arabia;American Hospital, Dubai, UAE;Bahrain Defense Force Hospital, Manama, Bahrain;Cleveland Clinic Abu Dhabi, Al Maryah Island, Abu Dhabi, United Arab Emirates;Department of Biochemistry, Sultan Qaboos University Hospital, Muscat, Oman;Department of Pharmacology and Clinical Pharmacy, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman;Department of Physiology, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman;Department of Surgery, Sultan Qaboos University Hospital, Muscat, Oman;Dubai Hospital, Dubai, UAE;Hamad Medical Corporation, Doha, Qatar;King Fahad General Hospital, Jeddah, Saudi Arabia;King Fahad Hospital of the University, Khobar, Saudi Arabia;King Fahad National Guard Hospital, Riyadh,Saudi Arabia;King Saud University, Riyadh, Saudi Arabia;Ministry of Health, Muscat, Oman;Ministry of Health, Riyadh, Saudi Arabia;Rashid Hospital, Dubai, UAE;Soliman Fakieh Hospital, Jeddah, Saudi Arabia;UAE University, Al Ain, UAE;

关键词: triglycerides;    cholesterol;    ldl;    cardiovascular diseases;    risk factors;    diabetes mellitus;    arabs;   

DOI  :  10.5001/omj.2022.79

来源: DOAJ

【 摘 要 】

Objectives: We sought to estimate the percentage achievements of non-high-density lipoprotein cholesterol (non-HDL-C) target in patients with very high atherosclerotic cardiovascular diseases (ASCVD) risk stratified by triglyceride (TG) levels despite statin-controlled low-density lipoprotein cholesterol (LDL-C) in the Centralized Pan-Middle East Survey on the under treatment of hypercholesterolemia. Methods: The non-HDL-C target achievement in patients with diabetes mellites (DM) and patients with established ASCVD was defined according to European Society of Cardiology and European Atherosclerosis Society 2019 guidelines for managing dyslipidemia. Patients were stratified to controlled LDL-C defined as < 70 mg/dL (< 1.8 mmol/L) with normal TG < 150 mg/dL (< 1.7 mmol/L) and high TG between 150–400 mg/dL (1.7–4.5 mmol/L). Results: The mean age of our cohort was 58.0±11.0 years, 6.8% (n = 717) were male, 9.7% (104) were smokers, and 48.4% (n = 518) had body mass index of ≥ 30 kg/m2. Those with high TG levels male (76.5% vs. 63.8%; p < 0.001), smokers (16.1% vs. 7.7%; p < 0.001), have metabolic syndrome (77.6% vs. 17.1%; p < 0.001), and low HDL-C levels (79.2% vs. 49.4%; p < 0.001). The majority (93.9%, n = 1008) were on statins (atorvastatin and rosuvastatin) with only 2.2% (n = 24) on the combined statins plus fenofibrate/gemfibrozil. Only 27.4% (n = 294) of patients had non-HDL-C goal attainment. Goal attainment rates in patients with diabetes (3.1% vs. 34,4%; p < 0.001), coronary artery disease (CAD) (2.4% vs. 37.9%; p < 0.001), diabetes plus CAD (0% vs. 40.0%; p < 0.001), and CVD (0% vs. 30.0%; p =0.048) were significantly lower in those with higher TG levels. Conclusions: A large proportion of statin-controlled LDL-C diabetic patients and patients with established ASCVD with high TGs did not achieve the non-HDL-C target. Our study did not demonstrate an association between ASCVD and high TG levels; and therefore, a follow-up study is highly required to assess long-term ASCVD outcomes in this cohort.

【 授权许可】

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