The Lipid Treatment Assessment Project (L-TAP)

TLDR

The study aimed to assess the proportion of patients on lipid‑lowering therapy who achieved LDL‑C goals per NCEP guidelines. The multicenter study evaluated 4,888 dyslipidemic adults on stable lipid‑lowering therapy, measuring LDL‑C once at enrollment and defining success as reaching NCEP target levels, stratifying patients into low‑risk, high‑risk, and established CHD groups. Only 38% of patients met NCEP LDL‑C targets overall, with 68% of low‑risk, 37% of high‑risk, and 18% of CHD patients achieving goals; drug therapy outperformed nondrug therapy, yet many treated patients failed to reach targets, underscoring the need for more aggressive dyslipidemia management.

Abstract

To determine the percentage of patients in the multicenter Lipid Treatment Assessment Project receiving lipid-lowering therapy who are achieving low-density lipoprotein cholesterol (LDL-C) goals as defined by National Cholesterol Education Program (NCEP) guidelines.Adult patients with dyslipidemia, who had been receiving the same lipid-lowering therapy for at least 3 months, were assessed at investigation sites. Lipid levels were determined once in each patient at the time of enrollment. The primary end point was the success rate, defined as the proportion of patients who achieved their LDL-C target level as specified by NCEP guidelines.A total of 4888 patients from 5 regions of the United States were studied. Of these, 23% had fewer than 2 risk factors for coronary heart disease (CHD) and no evidence of CHD (low-risk group), 47% had 2 or more risk factors and no evidence of CHD (high-risk group), and 30% had established CHD. Overall, only 38% of patients achieved NCEP-specified LDL-C target levels; success rates were 68% among low-risk patients, 37% among high-risk patents, and 18% among patients with CHD. Drug therapy was significantly (P< or =.001) more effective than nondrug therapy in all patient risk groups. However, many patients treated with lipid-lowering drugs did not achieve LDL-C target levels.Large proportions of dyslipidemic patients receiving lipid-lowering therapy are not achieving NCEP LDL-C target levels. These findings indicate that more aggressive treatment of dyslipidemia is needed to attain goals established by NCEP guidelines.