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Medicina issued since 1920

Volume 50, Issue 1, 2014

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Articles

Medicina (Kaunas) 2014; 50 (1): 44-53
DOI: 10.1016/j.medici.2014.05.003

Prevalence of dyslipidemia in statin-treated patients in the Baltic states (Estonia, Latvia, and Lithuania): Results of the Dyslipidemia International Study (DYSIS).

Margus Viigimaa 1
Andrejs Erglis 2,3,4
Gustavs Latkovskis 2,3,4
Ene Mäeots 5
Zaneta Petrulionienė 6
Rimvydas Slapikas 7
Anete Gocentiene 8
Peter Bramlage 9
Philippe Brudi 10
1 North Estonia Medical Centre, Tallinn University of Technology, Tallinn, Estonia
2 Latvian Centre of Cardiology, Pauls Stradins Clinical University Hospital, Riga, Latvia
3 Research Institute of Cardiology, University of Latvia, Riga, Latvia
4 Faculty of Medicine, University of Latvia, Riga, Latvia
5 East Tallinn Central Hospital, Tallinn, Estonia
6 Clinic of Heart and Vascular Medicine, Medical Faculty, Vilnius University, Lithuania
7 Medical Academy, Lithuanian University of Health Sciences, Kaunas, Lithuania
8 MSD UAB, Vilnius, Lithuania
9 Institut für Pharmakologie und Präventive Medizin, Mahlow, Germany
10 Merck & Co., Inc., Whitehouse Station, NJ, USA
Keywords
Cardiovascular disease
Dyslipidemia
High-density lipoprotein cholesterol
Low-density lipoprotein cholesterol
Statins
Triglycerides

The Baltic nations (Estonia, Latvia, and Lithuania) are profoundly affected by cardiovascular disease (CVD). Studies have indicated that patients may experience persistent dyslipidemia despite chronic statin treatment. Therefore, the aim of this study was to analyze the risk factors for dyslipidemia despite statin-treatment in a large dataset from the Baltic nations.
Patients in primary care centers across the Baltic nations were enrolled into the cross-sectional, observational Dyslipidemia International Study (DYSIS). Patients were ≥45 years old and had been treated with statins for at least three months. Patient characteristics and lipid measurements were used to determine variables contributing to dyslipidemia (abnormal low-density lipoprotein cholesterol [LDL-C], high-density lipoprotein cholesterol [HDL-C], or total triglyceride [TG] values).
We enrolled 1797 patients with a mean age of 66.1 years and 59.1% being female. Overall 63.4% had cardiovascular disease, 30.1% were diabetic and 77.8% at high risk for cardiovascular complications. LDL-C was not at target level for 80.7%; low HDL-C levels were observed for 26.0%, and elevated TG levels were found in 35.0% of all patients. Multivariate analyses indicated that a BMI≥30kg/m(2) (OR, 2.12; 95% CI, 1.45-3.08) and hypertension (OR, 2.43; 95% CI, 1.1 6-5.10) were strongly associated with dyslipidemia (involving all three lipids) during statin therapy while age ≥70 years (OR, 0.63; 95% CI, 0.42-0.94) and female gender (OR, 0.48; 95% CI, 0.33-0.68) conferred reduced risk.
Our findings indicate many statin-treated patients in Estonia, Latvia, and Lithuania did not meet target lipid levels and had a very high risk of CVD. Combating other well-known CVD risk factors such as obesity and hypertension is vital to reduce the exceptionally high risk for CVD mortality seen in the Baltic nations.

Correspondence to A. Erglis Latvian Centre of Cardiology, Pauls Stradins Clinical University Hospital, Pilsonu 13, 1002 Riga, Latvia. E-mail address: a.a.erglis@stradini.lv