Evaluation of the Effectiveness of Lipid Lowering Therapy in Real Clinical Practice

Aim. To evaluate hypolipidemic therapy in real clinical practice, the frequency of achieving target lipid values and the reasons for ineffective treatment of dyslipidemia.

Design. Retrospective prospective nonrandomized single-center continuous study.

Materials and methods. From 8655 persons referred to any department of Sechenov University, we selected those with documented dyslipidemia and patients prescribed or receiving lipid-lowering therapy. In the end, we selected 3812 patients. In the course of our work, we called all patients. Among those who agreed to participate in the study, we interviewed them: whether they were taking hypolipidemic agents, whether they controlled lipid spectrum parameters, whether they had cardiovascular complications (CVC), and concomitant pathologies. The risk of CCO was assessed during the telephone interview. All patients who required evaluation were invited for consultation at the Center. A total of 3282 patients' data were obtained.

Results. A total of 805 (24.5%) people out of 3282 agreed to be observed at our Center. 130 (16.2%) patients were regularly monitored by a cardiologist at the place of residence. Hypolipidemic therapy was received by 240 (29.8%) of respondents. It turned out that those with higher cardiovascular risk were less likely to reach target lipid values. The mean total cholesterol was 9.2 ± 5.9 mmol/L, LDL — 6.4 ± 3.7 mmol/L, and triglycerides — 2.8 ± 5.6 mmol/L. There were no people with low cardiovascular risk among our sample. The high-risk group included 292 (36.3%) patients, very high risk — 313 (38.9%), and extreme high — 72 (8.9%). In the high- and very high-risk subgroups, 6 and 7% of participants had target lipid levels before the start of follow-up at our Center, and there were no such patients in the extreme high-risk subgroup. Of 805 patients, 590 (73.3%) required correction of the regimen or initiation of hypolipidemic therapy. Among statins, rosuvastatin (n = 218, 36.9%), mean dose — 22.5 mg/day; atorvastatin (n = 165, 28%), mean dose — 56 mg/day; combination of rosuvastatin with ezetimibe at a dose of 10 mg/day (n = 124, 21%) and combination of atorvastatin with ezetimibe at a dose of 10 mg/day (n = 83, 14.1%) were used.

Conclusion. According to our study, the large number of patients have not achieved target lipid levels and the low percentage of patients with proven contraindications to the prescription of lipid-lowering therapy make it necessary to work more actively with patients for primary and secondary prevention of atherosclerosis by prescribing statins.

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