Authors
S Harikrishnan1, E Rajeev1, Jaganmohan A Tharakan1, T Titus1, VK Ajithkumar1, S Sivasankaran1, KM Krishnamoorthy1, Krishnakumar Nair1. 1Department of Cardiology, Sree Chitra Thirunal Institute of Medical Sciences and Technology, Trivandrum.
Abstract
Background: A history of coronary artery disease significantly increases cardiovascular risk. While statins are proven effective, many patients, particularly in India, may not achieve target lipid levels. This study aimed to assess if Indian CAD patients on statins achieve target lipid levels and discuss associated challenges.
Methods: We analyzed the lipid profiles of 852 consecutive angiographically proven coronary artery disease (CAD) patients on primary statin treatment for a minimum of 6 months (average 10.3 ± 2.2 months), against NCEP-ATP III goals. The mean age was 53.6 ± 7.9 years, with 75.7% males. Statin usage included atorvastatin (72%, mean 15.9mg), simvastatin (23%, mean 16.0mg), and lovastatin (4%, 14.5mg). Pre-treatment values were available for 446 patients.
Results: Only 359 (42.2%) patients achieved the LDL-C goal of <100mg% on statin treatment. Regarding other lipid goals, 59.1% had HDL-C levels >40 mg%, and 81% achieved triglyceride levels <150 mg%. Conclusion: The findings indicate that a majority of Indian CAD patients on statins do not achieve target LDL-C levels, a trend consistent with studies in Western populations. This highlights a critical need for improved strategies in clinical practice to achieve optimal lipid targets, with potential solutions involving more potent statins, combination therapies, and aggressive, patient-focused interventions.