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Cholesterol
Volume 2012 (2012), Article ID 861924, 7 pages
http://dx.doi.org/10.1155/2012/861924
Clinical Study

Use of Lipid-Lowering Medications and the Likelihood of Achieving Optimal LDL-Cholesterol Goals in Coronary Artery Disease Patients

1Cardiology Consultants of Philadelphia, Philadelphia, PA 19107, USA
2Division of Cardiology, Drexel University College of Medicine, Philadelphia, PA 19107, USA
3Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA 19107, USA

Received 17 April 2012; Revised 10 June 2012; Accepted 12 June 2012

Academic Editor: Jan Wouter Jukema

Copyright © 2012 Dean G. Karalis et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. In clinical practice, most coronary artery disease patients are not achieving their recommend LDL-cholesterol goal of <70 mg/dL. Methods. We conducted a retrospective analysis of outpatient electronic health records and the most recent lipid profile, lipid-lowering medications and doses were collected. Results. We identified 9950 coronary artery disease patients. Only 37% on a statin alone achieved an LDL-cholesterol of <70 mg/dL, and most were on moderate-to-high-potency statins. The intensity of statin therapy did not improve LDL-cholesterol goal attainment. Among patients on combination therapy, 41% on statin plus ezetimibe and 46% on statin plus niacin achieved an LDL-cholesterol of <70 mg/dL ( 𝑃 = 0 . 0 1 and <0.0001 versus statin alone). If patients were switched to a high-potency statin LDL-cholesterol goal attainment of <70 mg/dL would increase to 46% and would increase up to 72% with combination therapy. Conclusions. Most coronary artery disease patients in clinical practice do not attain an LDL-cholesterol of <70 mg/dL, even among patients on high potency statins. The combination of statin plus either ezetimibe or niacin is the most effective regimen to achieve an LDL-cholesterol of <70 mg/dL, however, these drug combinations are used infrequently in clinical practice.