1 Department of Cardiology, Toulouse Rangueil University Hospital, Toulouse, France; Department of Epidemiology and INSERM UMR 1027, Toulouse University School of Medicine, Toulouse, France.
2 Department of Molecular Medicine University of Pavia, and Cardiac Intensive Care Unit and Laboratories for Experimental Cardiology, IRCCS Fondazione Policlinico San Matteo, Pavia, Italy.
Eur J Prev Cardiol. 2018 Dec;25(18):1966-1976. doi: 10.1177/2047487318806359. Epub 2018 Oct 18.
Patients with coronary heart disease (CHD) and survivors of acute coronary syndrome (ACS) are at very high risk for adverse cardiovascular events. Lowering low-density lipoprotein cholesterol (LDL-C) can reduce the risk, with effective lipid-lowering therapy (LLT) readily available; however, dyslipidemia remains prevalent throughout Europe.
The observational Dyslipidemia International Study II (DYSIS II) aimed to identify unmet treatment needs in adult ACS and CHD patients. Data for the seven participating European countries are presented herein.
The study was carried out from December 2012 to November 2014. Use of LLT and attainment of European-guideline-recommended LDL-C targets were assessed. For ACS patients, changes in lipid levels and LLT were evaluated 4 months post-hospitalization.
Of the 4344 patients enrolled, 2946 were attending a physician visit for the assessment of stable CHD, while 1398 had been hospitalized for an ACS event. In both patient sets, mean LDL-C levels were high (89.5 and 112.5 mg/dl, respectively) and <70 mg/dl target attainment extremely poor. The mean daily statin dosage (normalized to atorvastatin potency) was 27 ± 20 mg for CHD and 22 ± 17 mg for ACS patients. Treatment was intensified slightly for ACS subjects after hospitalization, with the dosage reaching 35 ± 24 mg/day. LDL-C target attainment was higher by the end of the 4-month follow up (30.9% and 41.5% for patients on LLT and without LLT at baseline, respectively; p < 0.05).
Elevated blood cholesterol levels are highly prevalent across Europe, with low numbers of coronary patients reaching their recommended LDL-C target. While use of LLT is widespread, there is significant scope for intensifying treatment.
患有冠心病（CHD）和急性冠脉综合征（ACS）的幸存者发生不良心血管事件的风险极高。通过有效的降脂治疗（LLT）降低低密度脂蛋白胆固醇（LDL-C）可以降低风险；然而，血脂异常在整个欧洲仍然很普遍。
观察性血脂异常国际研究 II （DYSIS II）旨在确定成人 ACS 和 CHD 患者的未满足治疗需求。本文介绍了来自七个欧洲国家的数据。
该研究于 2012 年 12 月至 2014 年 11 月进行。评估了 LLT 的使用情况和达到欧洲指南推荐的 LDL-C 目标的情况。对于 ACS 患者，评估了住院 4 个月后血脂水平和 LLT 的变化。
在纳入的 4344 名患者中，2946 名患者正在就诊评估稳定型 CHD，1398 名患者因 ACS 住院。在这两组患者中，平均 LDL-C 水平均较高（分别为 89.5 和 112.5mg/dl），且<70mg/dl 的目标达标率极低。CHD 患者的平均每日他汀类药物剂量（以阿托伐他汀效力标准化）为 27±20mg，ACS 患者为 22±17mg。ACS 患者住院后治疗略有加强，剂量达到 35±24mg/天。在 4 个月的随访结束时，达到 LDL-C 目标的患者比例更高（接受 LLT 和未接受 LLT 的患者分别为 30.9%和 41.5%；p<0.05）。
在整个欧洲，血液胆固醇水平升高的情况非常普遍，只有少数冠心病患者达到了他们的 LDL-C 目标。虽然 LLT 的使用很广泛，但仍有很大的空间可以加强治疗。
