Germing Alfried, Lindstaedt Michael, Mügge Andreas
Medizinische Klinik II, Kardiologie und Angiologie, Berufsgenossenschaftliche Kliniken Bergmannsheil, Ruhr-Universität Bochum, Bürkle-de-la-Camp-Platz 1, 44789 Bochum.
Med Klin (Munich). 2005 Dec 15;100(12):781-4. doi: 10.1007/s00063-005-1108-z.
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.
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.
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.