Statins usage and target achievement of LDL-C level in Chinese patients with coronary artery disease impacted by 2013 ACC/AHA cholesterol guideline

Abstract

Background

Hypercholesterolemia is the accepted causal risk factor for atherosclerotic cardiovascular disease (ASCVD). 2013 ACC/AHA guideline on the treatment of cholesterol advised to tailor high-intensity statin for patients with coronary artery disease (CAD). However, its impact of real clinical practice has not been examined in China.

Methods

In this cross-sectional study, 3592 patients with CAD were consecutively enrolled who were receiving statins in outpatient department (at least 4 weeks) before they were admitted to the ward at five University hospitals from April 2011 to December 2015. Patients were divided into two groups according to the admission time before (group A, n = 1521) or after (group B, n = 2071) online announcement date of 2013 ACC/AHA guideline. The situation of statin application and LDL-C target achievement (LDL-C < 1.8 mmol/L) in both groups were compared.

Results

Data indicated that the constituent ratio of different kinds of statins usage was significantly different between the two groups (p < 0.05), and the proportion of rosuvastatin application grew up in group B (20.00%) when compared with group A (10.50%, p < 0.05). However, the mean dosage of atorvastatin or rosuvastatin had no significant change. More importantly, the achievement of LDL-C target in both groups was still extremely low (27.9% in group A vs. 26.9% in group B, p = 0.5077).

Conclusion

No much change of clinical practice with regard to cholesterol management was found in Chinese patients with CAD, accompanied by very low achievement of LDL-C target, suggesting that there is a great room for the improvement of cholesterol control in Chinese patients with CAD.