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The characteristics of two LDL-cholesterol level reduction treatment strategies, "treat-to-target" and "percent reduction": an observational study without intervention.

Abstract：

BACKGROUND:The 2014 ACC/AHA guidelines redefined the strategy for LDL-cholesterol (LDL-C) treatment. According to data from evidence-based studies, the basis for earlier therapeutic recommendations for LDL-C target levels (2.6 and 1.8 mmol/L) may be disputed, and only the data for the percent LDL-C reduction are objective. The target is a moderate intensity (30-50%) LDL-C reduction in the high cardiovascular (CV) risk group, and a high intensity LDL-C reduction (> 50%) in the very high risk group. In our study, we analysed the success of the two types of strategies in attaining the target in the everyday routine. METHODS:Of 5652 patients suffering from hypercholesterolemia, 4302 underwent treat-to-target treatment, and 1350 patients were treated with a percent reduction strategy. Physicians were free to choose the dosage and the target treatment form. The 12-month study included three follow-up visits. RESULTS:In the high CV risk, statin-naive subgroup the percent LDL-C reduction strategy has been proven to be clearly more successful than the treat-to-target strategy, i.e. a higher proportion of patients reached the target values. We observed that the absolute value corresponding to a percent reduction target is higher if the baseline LDL-C is higher, and therefore it is easier to reach. CONCLUSION:Therefore, in this large subgroup of patients with baseline LDL-C level higher than 3.9 mmol/L may be recommended the adaptation of the percent reduction assessment.

journal_name

BMC Cardiovasc Disord

journal_title

BMC cardiovascular disorders

authors

Császár A

doi

10.1186/s12872-019-1038-y

subject

Has Abstract

pub_date

2019-03-11 00:00:00

pages

57

issue

1

issn

1471-2261

pii

10.1186/s12872-019-1038-y

journal_volume

19

pub_type

杂志文章

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