Cor Vasa 2009, 51(2):92-96 | DOI: 10.33678/cor.2009.025

The usual dosage regimen of statins and adherence to target LDL-cholesterol levels by Czech patients in the secondary prevention of coronary heart disease

Otto Mayer jr.^1,*, Jaroslav Šimon¹, Jan Bruthans², Markéta Galovcová², Jana Hrbková¹, Jiří Bělohoubek²

¹ Centrum preventivní kardiologie II. interní kliniky, Univerzita Karlova Praha - Lékařská fakulta a Fakultní nemocnice v Plzni, Plzeň

² Pracoviště preventivní kardiologie, Institut klinické a experimentální medicíny, Praha, Česká republika

Background: Statins are a critical component of pharmacotherapy in the secondary prevention of coronary heart disease (CHD). It is evident from new-generation statin trials that aggressive lipid-lowering may further increase the benefit of CHD patients.

Aims: To determine the usual dosage regimen of statins and whether target values of LDL-cholesterol (LDL) are achieved in patients with manifest CHD.
Design of study: A descriptive, pragmatic survey of a systematically selected sample (EUROASPIRE III).

Methods: 600 consecutive patients, men and women aged ≤ 80 years, were identified retrospectively with the following diagnoses: coronary artery bypass graft, percutaneous transluminal coronary angioplasty or acute coronary syndrome. Data collection was based on a review of medical records and interview at least 6 months after hospital admission.

Results: In total, 473 responders were analyzed, out of which number, 86.9% were treated with statins. Overall, 43.6% of patients were treated with a standard dosage of statin (simvastatin 40 mg or equivalent), while at least 37.9% with only a substandard dosage -(simvastatin ≤ 20 mg or equivalent). Only 4.6% of subjects were treated more aggressively (atorvastatin ≥ 40 mg or simvastatin 80 mg). About 39% of patients reached the target value of LDL < 2.5 mmol/L, while only 19% the target value of LDL < 2.0 mmol/L.

Conclusion: Although the majority of CHD patients are currently being treated with statins, the usual dosage regimen and, most importantly, achievement of the recommended target values were not consistent with current standards in the secondary prevention of CHD.

Keywords: Secondary prevention; Statin; Dosage; Target value; EUROASPIRE III

Published: February 1, 2009  Show citation