BACKGROUND Real-world evidence of low-density lipoprotein cholesterol (LDL-C) goal attainment rates for Asian patients is deficient. The objective of this study was to assess the status of dyslipidemia management, especially in high-risk patients with cardiovascular disease (CVD) including stroke and acute coronary syndrome (ACS). METHODS This was a retrospective cohort study of 514,866 subjects from the National Health Insurance Service-National Health Screening Cohort database in Korea. Participants were followed up from 2002 to 2015. Subjects with a high-risk of CVD prior to LDL-C measurement and subjects who were newly-diagnosed for high-risk of CVD following LDL-C measurement were defined as known high-risk patients (n = 224,837) and newly defined high-risk patients (n = 127,559), respectively. Data were analyzed by disease status: stroke, ACS, coronary heart disease (CHD), peripheral artery disease (PAD), diabetes mellitus (DM) and atherosclerotic artery disease (AAD). RESULTS Overall, less than 50% of patients in each disease category achieved LDL-C goals (LDL-C < 70 mg/dL in patients with stroke, ACS, CHD and PAD; and LDL-C < 100 mg/dL in patients with DM and AAD). Statin use was observed in relatively low proportions of subjects (21.5% [known high-risk], 34.4% [newly defined high-risk]). LDL-C goal attainment from 2009 to 2015 steadily increased but the goal-achiever proportion of newly defined high-risk patients with ACS remained reasonably constant (38.7% in 2009; 38.1% in 2015). CONCLUSIONS LDL-C goal attainment rates in high-risk patients with CVD and DM in Korea demonstrate unmet medical needs. Proactive management is necessary to bridge the gap between the recommendations of clinical guidelines and actual clinical practice.

中文翻译：

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一项回顾性队列研究显示，韩国高危心血管疾病和糖尿病患者的低密度脂蛋白胆固醇目标达到率。

背景技术对于亚洲患者而言，低密度脂蛋白胆固醇（LDL-C）目标达到率的现实证据不足。这项研究的目的是评估血脂异常的治疗状况，尤其是在包括中风和急性冠脉综合征（ACS）在内的心血管疾病（CVD）高危患者中。方法这是一项回顾性队列研究，来自韩国国家健康保险局-国家健康筛查队列数据库中的514,866名受试者。参与者从2002年到2015年进行了随访。在LDL-C测量之前患有CVD的高风险受试者和LDL-C测量之后新诊断出CVD的高风险受试者被定义为已知的高危患者（ n = 224,837）和新定义的高危患者（n = 127,559）。通过疾病状况分析数据：中风，ACS，冠心病（CHD），外周动脉疾病（PAD），糖尿病（DM）和动脉粥样硬化性动脉疾病（AAD）。结果总的来说，每种疾病类别中不到50％的患者达到了LDL-C目标（中风，ACS，CHD和PAD患者的LDL-C <70 mg / dL；而中风患者的LDL-C <100 mg / dL DM和AAD）。在比例相对较低的受试者中观察到他汀类药物的使用（21.5％[已知的高风险]，34.4％[新定义的高风险]）。从2009年到2015年，LDL-C的目标达成率稳步上升，但新定义的ACS高危患者的目标达成率仍保持合理不变（2009年为38.7％； 2015年为38.1％）。结论韩国高风险的CVD和DM患者的LDL-C目标达到率表明医疗需求未得到满足。