Methods: DYSIS II is a multicenter, observational cross-sectional chart review conducted from November 2012-July 2013 in 93 outpatient care centers in Russia. Eligible adult patients had a documented history of CHD (past acute coronary syndrome (ACS) events >3 months before enrollment), full lipid profile available 0-12 months prior to enrollment, on LLT for =3 months or not treated at all, and were not participating in randomized clinical trials involving medication. Patient characteristics, risk factors, treatment patterns, and laboratory values were collected. LDL-C lipid target achievement was assessed based on local guidelines. Patients were identified as having hypertension based on data collected through the study case report form.
Results: Among 567 hypertensive stable CHD patients (74.8% male, mean age 62.5 ± 9.3 years), 95.2% had hypercholesterolaemia, 80.1% history of ACS, 71.9% previous percutaneous coronary intervention or coronary artery bypass graft, 61.6% left ventricular hypertrophy, 53.5% family history of CHD, 40.9% congestive heart failure, and 18.6% type 2 diabetes mellitus. 93.7% (n=531) of patients were on LLT (99.4% statin and 9.2% non-statin), with only 11.3% achieving LDL-C <70 mg/dl. Mean atorvastatin equivalent dose was 21 ± 13 mg/day, 8.7% of treated patients received combination therapy with 2.1% receiving ezetimibe plus statin.
Conclusion: Approximately 89% of LLT treated hypertensive patients with stable CHD in Russia did not achieve the recommended LDL-C target. Additional effective lipid lowering strategies are needed among these very high risk patients to prevent future cardiovascular events.