Persistent lipid abnormalities in statin-treated coronary artery disease patients with and without diabetes in China.

Background: We evaluate the prevalence of persistent lipid abnormalities and statin use in Chinese coronary artery disease patients with and without diabetes.

Methods And Results: In this cross-sectional observational study, 8965 outpatients from 200 clinical departments of 122 hospitals in 27 provinces nationwide of China who had coronary artery disease and were taking a statin were consecutively enrolled and divided into two groups based on diabetes status. The European Society of Cardiology/European Arthrosclerosis Society Guidelines for the management of dyslipidemias and the Chinese Guidelines on Prevention and Treatment of Dyslipidemia in Adults were used to compare the control rates of low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol, and triglycerides (TG). Among the 8965 participants, 33.3% had been diagnosed with diabetes mellitus. According to the ESC Guidelines, the percentage of patients with not at goal LDL cholesterol did not differ significantly between patients with diabetes and those without diabetes (71.9% vs. 72.7%, P=0.46). The percentages of patients with not-at-goal levels of HDL and TG were 42.9% vs. 34.4% (P<0.001) and 39.1% vs. 34.3% (P<0.001) among patients with diabetes and those without, respectively. Only approximately 10% of patients in both groups had optimal LDL-C, HDL-C, and TG levels. Compared with patients without diabetes, patients with diabetes were more likely to have mixed dyslipidemia. Atorvastatin (47.0%) and simvastatin (34.4%) were the two most frequently used statins, and the average statin dosage was 29.09mg/day (simvastatin equivalent). Less than 1% of patients were treated with another lipid-lowering drug in combination with a statin.

Conclusions: Although international guidelines highly recommend intensive lipid modulation in patients with coronary artery disease, persistent dyslipidemia is still prevalent among these patients in China, even with statin treatment.