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1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
2Division of Cardiology, Severance Cardiovascular Hospital, Yonsei University College of Medicine, Seoul, Korea
3Division of Endocrinology and Metabolism, Department of Internal Medicine, Korea University Guro Hospital, Seoul, Korea
4Division of Nephrology, Department of Internal Medicine, Chungnam National University Hospital, Chungnam National University College of Medicine, Daejeon, Korea
5Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
6Cardiovascular Division, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Seoul, Korea
7Division of Cardiology, Department of Internal Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
8Medical Affairs, Sanofi-Aventis Korea, Seoul, Korea
9Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
Copyright © 2020 Korean Endocrine Society
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
CONFLICTS OF INTEREST
One of the co-authors, Ji-Hyun Kim, is a current employee at Sanofi-Aventis Korea, but no potential conflict of interest was reported by the author.
This study was supported by Sanofi-Aventis Korea. Medical writing and editorial support in the preparation of this publication was provided by Satyendra Shenoy from Describe Scientific Writing & Communications who was paid for by Sanofi-Aventis Korea and Anahita Gouri and Rohan Mitra from Sanofi-Aventis Korea. The authors individually and collectively are responsible for all content and editorial decisions and received no payment from Sanofi-Aventis Korea directly or indirectly (through a third party) related to the development/presentation of this publication.
AUTHOR CONTRIBUTIONS
Conception or design: J.S.K., K.M.C., K.W.L., S.C.L., J.R.C., S.J.O., J.H.K., S.H.C. Acquisition, analysis, or interpretation of data: Y.S.Y., S.Y.L., J.S.K., K.M.C., K.W.L., S.C.L., J.R.C., S.J.O., J.H.K., S.H.C. Drafting the work or revising: Y.S.Y., S.H.C. Final approval of the manuscript: Y.S.Y., S.Y.L., J.S.K., K.M.C., K.W.L., S.C.L., J.R.C., S.J.O., J.H.K., S.H.C.
Characteristic | Risk category | Total (n=1,034) | ||||
---|---|---|---|---|---|---|
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Low (n=1) | Moderate (n=47) | High (n=178) | Very high (n=747) | Non-assessablea (n=61) | ||
Age in years | 30.0 | 56.2±7.9 | 60.9±9.5 | 64.5±10.4 | 62.6±11.0 | 63.3±10.4 |
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Gender | ||||||
Male | 0 | 12 (25.5) | 76 (42.7) | 455 (60.9) | 25 (41.0) | 568 (54.9) |
Female | 1 (100) | 35 (74.5) | 102 (57.3) | 292 (39.1) | 36 (59.0) | 466 (45.1) |
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History of dyslipidemia | 1 (100) | 47 (100) | 167 (93.8) | 536 (72.1) | 45 (73.8) | 796 (77.0) |
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Time in years since diagnosis of dyslipidemia | 1.0 | 4.1±3.0 | 5.1±3.6 | 5.0±3.7 | 4.2±2.8 | 4.9±3.6 |
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Prevalence of CV risk factors | ||||||
Hypertensionb | 1 (100) | 22 (46.8) | 100 (56.2) | 569 (76.2) | 38 (62.3) | 730 (70.6) |
Lack of physical activityc | 1 (100) | 30 (63.8) | 104 (58.4) | 446 (59.7) | 40 (65.6) | 621 (60.1) |
Diabetesd | 0 | 0 | 140 (78.7) | 377 (50.5) | 0 | 517 (50.0) |
Regular alcohol consumptione | 0 | 4 (8.5) | 32 (18.0) | 143 (19.1) | 11 (18.0) | 190 (18.4) |
Familial history of CVDf | 0 | 7 (14.9) | 32 (18.0) | 137 (18.3) | 12 (19.7) | 188 (18.2) |
Current smokingg | 0 | 1 (2.1) | 19 (10.7) | 116 (15.5) | 8 (13.1) | 144 (13.9) |
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CV comorbidities | ||||||
CAD | 0 | 0 | 0 | 424 (56.8) | 0 | 424 (41.0) |
ACS/MIh (n=424) | NA | NA | NA | 254 (59.9) | NA | 254 (59.9) |
PCIh (n=424) | NA | NA | NA | 246 (58.0) | NA | 246 (58.1) |
CABGh (n=424) | NA | NA | NA | 16 (3.8) | NA | 16 (3.8) |
Stroke | 0 | 0 | 0 | 140 (18.7) | 0 | 140 (13.5) |
CKDi | 1 (100.0) | 9 (19.1) | 9 (5.1) | 94 (12.6) | 5 (8.2) | 118 (11.4) |
Values are expressed as mean±standard deviation or number (%).
CV, cardiovascular; CVD, cardiovascular disorder; CAD, coronary artery disease; ACS, acute coronary syndrome; MI, myocardial infarction; NA, not applicable; PCI, percutaneous intervention; CABG, coronary artery bypass graft; CKD, chronic kidney disease.
a Patients without a serious pathology classifying them as very high or high cardiovascular risk, and in whom the Systematic COronary Risk Evaluation (SCORE) could not be calculated due to missing data (most commonly baseline low-density lipoprotein cholesterol);
b Systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg or a previous history of hypertension;
c Patient is not regularly involved in moderate (walking/cycling/gardening) or strenuous exercise (jogging/football/vigorous swimming) for ≥4 hours each week;
d Type 1 or 2 diabetes mellitus;
e Consumption ≥3 times a week;
F Coronary and/or vascular disease <55 years of age in male and <60 years in female first-degree relatives;
g Current smokers and individuals who smoked any tobacco in the previous 12 months (including those who have quit smoking within the previous 12 months);
h Only assessed in patients with CAD;
i GFR <60 mL/min/1.73 m2.
Risk assessed by investigator | Risk category | Total (n=1,034) | ||||
---|---|---|---|---|---|---|
Low (n=1) | Moderate (n=47) | High (n=178) | Very high (n=747) | Non-assessablea (n=61) | ||
Low | 0a | 20 (42.6) | 39 (21.9) | 65 (8.7) | 14 (23.0) | 138 (13.3) |
Moderate | 1(100) | 23 (48.9)a | 41 (23.0) | 226 (30.3) | 39 (63.9) | 330 (31.9) |
High | 0 | 4 (8.5) | 82 (46.1)a | 306 (41.0) | 6 (9.8) | 398 (38.5) |
Very high | 0 | 0 | 16 (9.0) | 150 (20.1)a | 2 (3.3) | 168 (16.2) |
Variable | Risk category | Total (n=1,034) | ||||
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Low (n=1) | Moderate (n=47) | High (n=178) | Very high (n=747) | Non-assessablea (n=61) | ||
Lipid-modifying treatment | ||||||
Statins | 1 (100) | 47 (100) | 169 (94.9) | 729 (97.6) | 58 (95.1) | 1,004 (97.1) |
Fibrates | 0 | 0 | 10 (5.6) | 27 (3.6) | 4 (6.6) | 41 (4.0) |
Omega-3 fatty acids | 0 | 2 (4.3) | 8 (4.5) | 29 (3.9) | 1 (1.6) | 40 (3.9) |
Cholesterol absorption inhibitors | 0 | 6 (12.8) | 6 (3.4) | 19 (2.5) | 0 | 31 (3.0) |
Others | 0 | 0 | 0 | 6 (0.8) | 0 | 6 (0.6) |
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Patients receiving high-intensity statinsb | 0 | 2 (4.3) | 9 (5.3) | 66 (9.1) | 1 (1.7) | 78 (7.8) |
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Patients receiving highest permissible dose of statins | 0 | 2 (4.3) | 15 (8.9) | 53 (7.3) | 4 (6.9) | 74 (7.4) |
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Reason for not prescribing the highest dose of statins | ||||||
Assessed number of patients | 1 | 45 | 154 | 664 | 54 | 918 |
Physician satisfactionc | 0 | 35 (77.8) | 141 (91.6) | 550 (82.8) | 50 (92.6) | 776 (84.5) |
Medically inappropriated | 1 (100) | 9 (20.0) | 9 (5.8) | 154 (23.2) | 13 (24.1) | 186 (20.3) |
Statin intolerancee | 0 | 1 (2.2) | 4 (2.6) | 15 (2.3) | 0 | 20 (2.2) |
Values are expressed as number (%).
a Patients without a serious pathology classifying them as very high or high cardiovascular risk, and in whom the Systematic COronary Risk Evaluation (SCORE) could not be calculated due to missing data (most commonly baseline low-density lipoprotein cholesterol [LDL-C]);
b Atorvastatin 40/80 mg or rosuvastatin 20/40 mg;
c Physician determined that the patient’s LDL-C levels were appropriate;
d Higher dose not advisable due to patient’s clinical condition;
e Patient did not tolerate a higher dose regimen or a higher intensity statin.