P277 Dyslipidemia in patients undergoing percutaneous coronary interventions - effectiveness of treatment in “real life”.
A.Germing, P.Grewe, W.Bojara, T.Lawo, B.Lemke, A.Mügge
Medizinische Klinik II, Kardiologie / Angiologie, BG-Kliniken Bergmannsheil, Ruhr-Universität, Bochum.

Background: Dyslipidemia is an independent cardiovascular risk factor. Lowering increased lipid levels is a major concern in the treatment of patients with coronary artery disease (CAD) to reduce restenosis after percutaneous coronary intervention (PCI). Although effective treatment strategies are available, “real life cardiology” has to deal with increased lipids.

Methods: A total of 294 unselected patients (62.2% male, 65.5+10.9 years) with symptomatic CAD were included between January 2001 and October 2002. We compared the lipid status at the time an elective PCI was performed (date 1) and at the time of repeated angiography (date 2) (mean follow-up 5.5 months). Routine control angiography was not planned, but was scheduled in symptomatic patients or an unclear morphologic or functional situation. The following parameters have been measured: total cholesterol (TC), high-density cholesterol (HDL), low-density-cholesterol (LDL), triglycerides (TG), lipoprotein(a) (LPA) and fibrinogen (FIB). In most patients the blood-sample was taken the day before elective intervention.

Results: At ate 1 91.5% of patients presented a dyslipidemia and 49.8% were treated with lipid-lowering drugs. At dtae 2 87.5% were treated with lipid-lowering drugs. Angiography showded a restenosis in 36.9%. These results (mg/dl) were documented at date 1 and 2, respectively: TC (205+50, 182+43), TG (164+87, 172.114), HDL (45.28, 42+14), LDL (138+41, 118+34), LPA (247+225, 278+209), FIB (396+102, 381+90). The results show that there is no statistically significant change in lipid levels over the period. Conclusions: In an unselected patient group undergoing elective PCI there was no significant change in levels of the lipid status over a mean period of 5.5 months. Although the majority were treated with lipid-lowering drugs, the therapy was not effective. All person involved in the treatment of patients with CAD should focus on the relevance of dyslipidemia, and the effectiveness of the therapeutic strategy should be reconsidered often. The cooperation between interventionalist and primary care physician has to be improved.