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Meeting UK national targets for lipids in acute coronary syndrome with early and intensive lipid reduction: a single centre District general hospital experience

Homerton University Hospital, London, UK

Marianna Mela

Chest Medicine, Papworth Hospital, Cambridge, UK

Ian Eustace

Sandeep Gupta

Department of Cardiology, Whipps Cross and St Bartholomews Hospitals, London, UK, sgupta111{at}aol.com

Acute coronary syndrome (ACS) remains the leading cause of death in the industrialised world and is ever increasing in developing populations. This study assesses the safety and effectiveness of atorvastatin 40 mg in meeting new targets for lipids in patients presenting to the coronary care unit with ACS. A group of 79 consecutive patients admitted with ACS were initiated on or changed to atorvastatin 40 mg during admission. The reduction in total cholesteron (TC), low density lipoprotein-cholesterol (LDL-C) and incidence of any adverse effects were assessed at one week, one month and three months after hospitalisation. At baseline only 13% and 23% of patients had their TC and LDL-C respectively within Joint British Societies 2 (JBS2) national institute for Health and Clinical Excellence (NICE) targets for patients with cardiovascular disease. After 1 month of atorvastatin therapy these values had increased to 77% and 70% respectively with an absolute reduction in TC and LDL-C of 30%. At baseline 47% and 50% of patients had TC and LDL-C within National Service framework (NSF) targets at baseline, however, 1 week after atorvastatin therapy the proportion of patients achieving NSF targets increased to 88% and 84% for TC and LDL-C respectively. These data suggest that early and intensive reduction of lipids with atorvastatin 40 mg for ACS patients in hospital is a safe and effective strategy to meet recommended targets for lipids. Br J Diabetes Vasc Dis 2008; 8: 286—290

Key Words: acute coronary syndrome • atorvastatin • lipids • national targets

References

• Department of Health. National Service Framework for Coronary Heart Disease. London: Crown Copyright, 2000: 16602. http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4094275 (Accessed August 2008).
• Evans PH, Luthra M., Pike C. et al. NSF lipid targets in patients with CHD: are they achievable in a real-life primary care setting? Br J Cardiol 2004; 11:71-4.
• Middleton A., Fuat F. Achieving Lipid Goals in Real Life: The DISCOVERY-UK Study. Br J Cardiol 2006; 13:72-6.
• JBS 2: Joint British Societies' guidelines on prevention of cardiovascular disease in clinical practice. Heart 2005; 91 (suppl 5):v1-v52.[Free Full Text]
• Cooper A., Nherera L., Calvert N. et al. Clinical Guidelines and Evidence Review for Lipid Modification: cardiovascular risk assessment and the primary and secondary prevention of cardiovascular disease. London: National Collaborating Centre for Primary Care and Royal College of General Practitioners, 2008.
• Davies A., Hutton J., O'Donnell J. et al. Cost-effectiveness of rosuvastatin, atorvastatin, simvastatin, pravastatin and fluvastatin for the primary prevention of CHD in the UK. Br J Cardiol 2006; 13:196-202.

The British Journal of Diabetes & Vascular Disease, Vol. 8, No. 6, 286-290 (2008)
DOI: 10.1177/1474651408097904


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This Article Abstract Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Add to Saved Citations Download to citation manager Request Permissions Request Reprints Add to My Marked Citations Citing Articles Citing Articles via Google Scholar Citing Articles via Scopus Google Scholar Articles by Kuppuswamy, V. Articles by Gupta, S. Search for Related Content Social Bookmarking                         What's this?