The reasons of poor lipid target attainment for secondary prevention in real life practice: Results from EPHESUS

Abstract

Objective: There are lack of studies considering the suboptimal management of dyslipidemia especially in cardiology outpatient clinics. This study was conducted to assess the patient adherence to cholesterol treatment recommendations and attainment of low-density-lipoprotein cholesterol (LDL-C) goals.Methods: EPHESUS (NCT02608645) is a national, observational and multicenter registry which has been designed as a cross-sectional study to allow inclusion of all consecutive patients with hypercholesterolemia in cardiology outpatient clinics.The present subgroup analyses of the EPHESUS trial included patients with known peripheral artery disease or atherosclerotic cerebrovascular disease, and coronary heart disease namely secondary prevention. Results:The present analysis of the EPHESUS study included 1482 patients (62.79 ± 10.4 years, 38.2% female) with secondary prevention from 40 sites in Turkey.Regarding recommended lipid targets for LDL-C, only 267 patients (18%) were below the target of 70 mg/dL. Females were significantly more off-target when compared with male patients (396, 85.5% vs 67, 14.5%; P = 0.017). Moreover, the achievement of LDL-C goal was significantly decreased with illiteracy (233, 19.2% vs 35, 13.1%; P = 0.02). Patients who think that the cholesterol treatment should be terminated when the cholesterol level of a patient has normalised were higher in the off-target group (34.0% vs 24.7%, P < 0.001). Besides, physician perceptions about LDL-C goal for secondary prevention were significantly related with LDL-C target attainment. Conclusions:EPHESUS is an important study with large population in terms of representing real-life practice of the adherence to dyslipidemia guidelines in secondary prevention patients in Turkey. Perceptions, knowledge, and compliance with the guidelines for secondary prevention have increased, but it is far below from the

Prevalence and Predictors of Out-of-Target LDL Cholesterol 1 to 3 Years After Myocardial Infarction. A Subanalysis From the EYESHOT Post-MI Registry

“…Consistently with previous observations, 18,19,23,24 in our study higher level of education was associated with greater LDL-C goal achievement. Socioeconomic indicators may affect multiple spheres of individual life, including the opportunities of access to health-care facilities and the adherence to long-term therapy.…”

“…18 A recent subanalysis from the EPHESUS study, a cross-sectional Turkish registry enrolling patients with atherosclerotic diseases, documented the achievement of the LDL-C goal in only 18% of cases. 19 The attainment of LDL-C target was even lower in a cohort of patients with recent acute coronary syndrome enrolled in a retrospective Germany registry, being observed in just 11.5% of cases. 20 In comparison with these studies, our analysis included a selected population of subjects who experienced MI more than a year prior enrollment.…”

Low-Density Lipoprotein Cholesterol Targets in Patients With Coronary Heart Disease in Extremadura (Spain): LYNX Registry

“…The EPHESUS registry [24] included 1,482 secondary prevention patients (63 ± 10 years, 38% women), and only 18% achieved an LDL-C < 70 mg/dL; and as it was seen in other countries, fewer women were treated properly (86% vs. 15%; P = 0.017).…”

“…In the CEPHEUS registry, conducted in 29 countries in the Middle East, only 22.8% of patients with CAD achieved the LDL-C target of < 70 mg/dL [23], and in the EPHESUS study, conducted in 40 centers in Turkey, only 18% [24].…”

Treating lipids in secondary prevention in a developing country: Lies, damn lies and the internet

“…In this issue of IJCP Mert et al present large‐scale registry data on treatment of lipids in secondary prevention in Turkey . Turkey has a younger demographic profile compared with Western European countries but has a high prevalence of dyslipidaemia, diabetes and CVD.…”