Non-high-density lipoprotein cholesterol target achievement in patients on lipid-lowering drugs and stratified by triglyceride levels in the Arabian Gulf

Khamis Al-Hashmi, Ibrahim Al-Zakwani, Wael Al Mahmeed, Mohammed Arafah, Ali T. Al-Hinai, Abdullah Shehab, Omer Al Tamimi, Mahmoud Al Awadhi, Shorook Al Herz, Faisal Al Anazi, Khalid Al Nemer, Othman Metwally, Akram Alkhadra, Mohammed Fakhry, Hossam Elghetany, Abdel Razak Medani, Afzal Hussein Yusufali, Obaid Al Jassim, Omar Al Hallaq, Fahad Omar Ahmed S BaslaibHaitham Amin, Raul D. Santos, Khalid Al-Waili, Khalid Al-Rasadi

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Atherogenic dyslipidemia is highly prevalent in the Arabian Gulf. Non-high-density lipoprotein cholesterol (non-HDL-C) reduction has been proposed as an additional goal to low-density lipoprotein cholesterol (LDL-C) lowering to prevent atherosclerotic cardiovascular disease (ASCVD). Data on non-HDL-C goal attainment in patients with high triglycerides (TGs) on lipid-lowering drugs (LLDs) in the region is scarce. Objective: Evaluate non-HDL-C target attainment according to the National Lipid Association in patients on LLDs stratified by TG (200 [2.26] mg/dL [mmol/L]) levels in the Arabian Gulf. Methods: Overall, 4383 patients on LLD treatment from 6 Middle Eastern countries participating in the Centralized Pan-Middle East Survey on the Undertreatment of Hypercholesterolemia study were evaluated. Patients were classified according to TG levels and ASCVD risk. Results: The overall non-HDL-C goal attainment was 41% of the subjects. Non-HDL-C goal was less likely attained in patients with high TGs (12% vs 27% vs 55%; P <.001). Very high ASCVD risk patients with high TGs attained less their non-HDL-C targets compared with those with lower TG levels (8% vs 23% vs 51%; P <.001). Similarly, high ASCVD risk patients with high TGs also failed more in attaining non-HDL-C targets compared with those with lower TGs (26% vs 42% vs 69%; P <.001). In addition, those with high TG also succeeded less in attaining LDL-C and apolipoprotein B goals (P <.001). Conclusions: A large proportion of very high and high ASCVD patients on LLDs in the Arabian Gulf are not at recommended non-HDL-C targets and hence remain at a substantial residual risk.

Original languageEnglish
JournalJournal of Clinical Lipidology
DOIs
Publication statusAccepted/In press - Aug 25 2015

Keywords

  • Apolipoprotein B
  • Cardiovascular diseases
  • Diabetes mellitus
  • HDL cholesterol
  • LDL cholesterol
  • Middle East
  • Non-HDL cholesterol
  • Triglycerides

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Endocrinology, Diabetes and Metabolism
  • Internal Medicine
  • Nutrition and Dietetics

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    Al-Hashmi, K., Al-Zakwani, I., Al Mahmeed, W., Arafah, M., Al-Hinai, A. T., Shehab, A., Al Tamimi, O., Al Awadhi, M., Al Herz, S., Al Anazi, F., Al Nemer, K., Metwally, O., Alkhadra, A., Fakhry, M., Elghetany, H., Medani, A. R., Yusufali, A. H., Al Jassim, O., Al Hallaq, O., ... Al-Rasadi, K. (Accepted/In press). Non-high-density lipoprotein cholesterol target achievement in patients on lipid-lowering drugs and stratified by triglyceride levels in the Arabian Gulf. Journal of Clinical Lipidology. https://doi.org/10.1016/j.jacl.2015.12.021