Lipid levels among contemporary patients hospitalized with coronary artery disease
(CAD) have not been well studied. This study aimed to analyze admission lipid levels
in a broad contemporary population of patients hospitalized with CAD.
The Get With The Guidelines database was analyzed for CAD hospitalizations from 2000
to 2006 with documented lipid levels in the first 24 hours of admission. Patients
were divided into low-density lipoprotein cholesterol (LDL), high-density lipoprotein
cholesterol (HDL), and triglyceride categories. Factors associated with LDL and HDL
levels were assessed along with temporal trends.
Of 231,986 hospitalizations from 541 hospitals, admission lipid levels were documented
in 136,905 (59.0%). Mean lipid levels were LDL 104.9 +/- 39.8, HDL 39.7 +/- 13.2,
and triglyceride 161 +/- 128 mg/dL. Low-density lipoprotein cholesterol <70 mg/dL
was observed in 17.6% and ideal levels (LDL <70 with HDL > or =60 mg/dL) in only 1.4%.
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. Predictors
for higher LDL included female gender, no diabetes, history of hyperlipidemia, no
prior lipid-lowering medications, and presenting with acute coronary syndrome. Both
LDL and HDL levels declined over time (P < .0001).
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 > or =60 mg/dL. These findings may provide further support for
recent guideline revisions with even lower LDL goals and for developing effective
treatments to raise HDL.