Objectives ESC/EAS Guidelines for the management of dyslipidaemias in 2011 recommended patients with documented coronary artery disease (CAD) or type 2 diabetes mellitus (DM) be risk-stratified into very high risk category and that the treatment targets for low density lipoprotein cholesterol (LDL-C) and apolipoprotein B (apo B) be <1.8 mmol/L and <0.8 g/L, respectively. The apo B, an emerging biomarker for cardiovascular risk prediction, appears to be superior to the LDL-C. However, little is known about goal attainments and their discrepancies for LDL-C and apo B in Chinese patients with known CAD or DM.
Methods A total of 2172 hospitalised patients with known coronary artery disease or DM, aged >27 years of old, were enrolled. The success rates for apo B and LDL-C goal attainments were evaluated and compared by categorisation and by sex.
Results Overall, 26.15% and 37.80% of patients attained LDL-C and apo-B goals, respectively. When the success rates of LDL-C and apo B were evaluated by the categorisation, the success rates were lowest (18.29% and 30.70%, respectively) in DM alone patients as compared with CAD alone patients (44.29% and 55.71%, respectively) and with coexistence of CAD and DM patients (40.00% and 46.50%, respectively) (P = 0.000 between group comparisons). The trend toward to higher success rates for LDL-C and apo B in men than in women has been found across all categorisations although only in all patients and in DM alone were the statistically significant differences found (P = 0.000). When the success rates for apo B were compared with the ones for LDL-C, the apo B goal attainment rates were all higher than the LDL-C’s across all categorisations, with the statistically significant differences seen in all patients, CAD alone and DM alone (P = 0.000), but not in coexistence of CAD and DM (P = 0.190). The trend toward to higher success rates for LDL-C and apo B goal attainments in men than in women are noteworthy across all categorisations although only in all patients and in DM alone patients were the statistically significant differences found (P < 0.01).
Conclusions The LDL-C lags behind the apo B in goal attainments in Chinese patients on stable statin therapy for at least 3 months. Whether these discrepancies are associated with the occurrence differences for CAD and for stroke between the East Asia and the Western countries warrants further study.