The Achievement of Non-high-density Lipoprotein Cholesterol Target in Patients with Very High Atherosclerotic Cardiovascular Disease Risk Stratified by Triglyceride Levels Despite Statin-controlled Low-density Lipoprotein Cholesterol

Hilal Al-Sabti, Ali T. Al-Hinai, Ibrahim Al-Zakwani, Khamis Al-Hashmi, Wael Al Mahmeed, Mohamed Arafah, 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 HallaqFahad Omar Ahmed S. Baslaib, Haitham Amin, Khalid Al-Waili, Khalid Al-Rasadi*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


Objectives: We sought to estimate the percentage achievements of non-high-density lipoprotein cholesterol (non-HDL-C) target in patients with very high atherosclerotic cardiovascular diseases (ASCVD) risk stratified by triglyceride (TG) levels despite statin-controlled low-density lipoprotein cholesterol (LDL-C) in the Centralized Pan-Middle East Survey on the under treatment of hypercholesterolemia. Methods: The non-HDL-C target achievement in patients with diabetes mellites (DM) and patients with established ASCVD was defined according to European Society of Cardiology and European Atherosclerosis Society 2019 guidelines for managing dyslipidemia. Patients were stratified to controlled LDL-C defined as < 70 mg/dL (< 1.8 mmol/L) with normal TG < 150 mg/dL (< 1.7 mmol/L) and high TG between 150–400 mg/ dL (1.7–4.5 mmol/L). Results: The mean age of our cohort was 58.0±11.0 years, 6.8% (n = 717) were male, 9.7% (104) were smokers, and 48.4% (n = 518) had body mass index of ≥ 30 kg/m2. Those with high TG levels male (76.5% vs. 63.8%; p < 0.001), smokers (16.1% vs. 7.7%; p < 0.001), have metabolic syndrome (77.6% vs. 17.1%; p < 0.001), and low HDL-C levels (79.2% vs. 49.4%; p < 0.001). The majority (93.9%, n = 1008) were on statins (atorvastatin and rosuvastatin) with only 2.2% (n = 24) on the combined statins plus fenofibrate/gemfibrozil. Only 27.4% (n = 294) of patients had non-HDL-C goal attainment. Goal attainment rates in patients with diabetes (3.1% vs. 34,4%; p < 0.001), coronary artery disease (CAD) (2.4% vs. 37.9%; p < 0.001), diabetes plus CAD (0% vs. 40.0%; p < 0.001), and CVD (0% vs. 30.0%; p = 0.048) were significantly lower in those with higher TG levels. Conclusions: A large proportion of statin-controlled LDL-C diabetic patients and patients with established ASCVD with high TGs did not achieve the non-HDL-C target. Our study did not demonstrate an association between ASCVD and high TG levels; and therefore, a follow-up study is highly required to assess long-term ASCVD outcomes in this cohort.

Original languageEnglish
Article numbere367
JournalOman Medical Journal
Issue number2
Publication statusPublished - May 2022


  • Arabs
  • Cardiovascular Diseases
  • Cholesterol
  • Diabetes Mellitus
  • LDL
  • Risk Factors
  • Triglycerides

ASJC Scopus subject areas

  • Medicine(all)

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