A colleague of mine recently refreshed us  with the AHA  “Get With the Guidelines”* data from 2008 that  revealed that nearly 75% of 137,000 patients admitted to the hospital with CAD had LDL levels below 130 mg/dL and nearly 50% had LDL levels below 100 mg/dL.

I think the key points in over 200K CAD admissions:

1.  Mean lipid levels were LDL 104.9 ± 39.8, HDL 39.7 ± 13.2, and triglyceride 161 ± 128 mg/dL.

2.  Low-density lipoprotein cholesterol <70 mg/dL was observed in 17.6% and ideal levels (LDL <70 with HDL ≥60 mg/dL) in only 1.4%.

3.  High-density lipoprotein cholesterol was <40 mg/dL in 54.6% of patients. Before admission, only 28,944 (21.1%) patients were receiving lipid-lowering medications.

4.  Conclusions: In a large cohort of patients hospitalized with CAD, almost half have admission LDL levels <100 mg/dL.  More than half the patients have admission HDL levels <40 mg/dL, whereas <10% have HDL ≥60 mg/dL.

5.  I think it is no big surprise that just over 20% were on lipid meds prior to the event.  The shocking issue is that 47% had CAD/Athero/DM and should have ALL been on lipid therapy with likely target LDLc under 70 (only 17% had this value).  Also, we know that LDLc when not directly measured in these settings usually gives a falsely low LDLc.

Access “Get with the Guidelines” by clicking here. I’m interested in your comments and urge you to share your opinions below.

* Lipid levels in patients hospitalized with coronaryartery disease: An analysis of 136,905 hospitalizations in Get With The Guidelines, American Heart Journal, Jan. 2009. Amit Sachdeva, MD, Christopher P. Cannon, MD, Prakash C. Deedwania, MD, Kenneth A. LaBresh, MD, Sidney C. Smith, Jr, MD, David Dai, MS, Adrian Hernandez, MD, and Gregg C. Fonarow, MD a on behalf of the GWTG Steering Committee and Hospitals Los Angeles and San Francisco, CA; Boston and Waltham, MA; and Chapel Hill and Durham, NC