295 Dysmetabolic profile in patients with established coronary heart disease

PurposeCurrent guidelines recommend lowering LDL-cholesterol below 2.6 mmol/L in patients with established cardiovascular disease. The potential benefit of an additional decrease in LDL-cholesterol has been suggested for coronary heart disease patients with diabetes or dysmetabolic profile, as they are at high risk of recurrence. The aim of this analysis was to estimate the proportion of patients with poor metabolic profile among those with established coronary heart disease.MethodsA sample of French male patients with a history of acute coronary syndrome was recruited from 2001 to 2004. Those with recent (in the past two months) acute coronary syndrome were excluded.ResultsThe sample comprised 824 men. Mean age was 60.3 years (standard deviation: 7.9), 22% of patients were still current smokers and 65% had high blood pressure (≥ 140/90 or 130/80 mmHg if diabetes). Diabetes was encountered in 32% of patients (20%, 36% and 38% from the 10-year age group 45-54 to 65-74 years, respectively, p<0.0001), low HDL-cholesterol (< 1 mmol/L) was observed in 42% (48%, 43%, 36%, p=0.021), high triglycerides (≥ 1.7 mmol/L) in 48% (58%, 49%, 38%, p<0.0001), and high non-HDL cholesterol (≥ 3.4 mmol/L) in 74% of patients (84%, 77%, 64%, p<0.0001). The combination of high non-HDL cholesterol and high triglycerides which reflects the atherogenic potential associated with remnant lipoproteins was encountered in 42% of patients (54%, 42%, 31%, p<0.0001) and 24% (32%, 24%, 17%, p