Preventive cardiologyAchieving Optimal Lipid Goals in Patients With Coronary Artery Disease
Section snippets
Methods
The study site was Cardiology Consultants of Philadelphia, a large cardiology subspecialty practice in the Philadelphia area. Using an electronic medical record, we identified 23,408 patients with histories of CAD who had been seen at 1 of our outpatient offices over a 12-month period from September 2008 to September 2009. Patients were excluded if they did not have a complete lipid profile in the electronic medical record flow sheet dated within the study period or within 6 months of their
Results
A total of 10,040 patients with CAD met the criteria for inclusion in the study. The clinical characteristics of the patients are listed in Table 1. Among patients prescribed ezetimibe, 88% were also taking statins, while the remaining 12% were treated with ezetimibe alone. Among patients prescribed fibrates, 61% were taking fenofibrate, 23% fenofibric acid, and 16% gemfibrozil.
Overall, 79% of patients achieved the LDL cholesterol goal of <100 mg/dl, while only 35% achieved the lower LDL
Discussion
Since the National Cholesterol Education Program update published in 2004,9 overall LDL goal achievement has improved. The results of our study demonstrate that most patients with CAD are achieving the minimal National Cholesterol Education Program LDL cholesterol goals,10 but few patients in clinical practice are achieving the more aggressive LDL cholesterol goal of <70 mg/dl. Similarly, few are achieving the non-HDL cholesterol goal of <100 mg/dl.
In the recently published Lipid Treatment
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