• 1 Department of Cardiology, National University Heart Centre Singapore, National University Health System, Singapore
  • 2 Department of Cardiology, National Heart Centre Singapore, Singapore
  • 3 Department of Cardiology, Changi General Hospital, Singapore
  • 4 Mount Elizabeth Medical Centre, Singapore
  • 5 Merck Sharp & Dohme (Malaysia) Sdn Bhd, Petaling Jaya, Selangor, Malaysia
  • 6 MSD Pharma (Singapore) Pte Ltd, Singapore
  • 7 Herzzentrum Ludwigshafen, Cardiology, Stiftung Institut für Herzinfarktforschung, Ludwigshafen, Germany
  • 8 University of Rhode Island, College of Pharmacy, Department of Pharmacy Practice, Kingston, RI, USA
  • 9 Merck & Co Inc, Kenilworth, NJ, USA
Singapore Med J, 2019 Sep;60(9):454-462.
PMID: 30773600 DOI: 10.11622/smedj.2019021


INTRODUCTION: Dyslipidaemia is a major risk factor for coronary heart disease (CHD). There is a lack of data on the extent of lipid abnormalities and lipid-lowering therapy (LLT) in Singapore.

METHODS: The Dyslipidemia International Study (DYSIS) II was a multinational observational study of patients with stable CHD and hospitalised patients with an acute coronary syndrome (ACS). A full lipid profile and use of LLT were documented at baseline, and for the ACS cohort, at four months post-hospitalisation.

RESULTS: 325 patients were recruited from four sites in Singapore; 199 had stable CHD and 126 were hospitalised with an ACS. At baseline, 96.5% of the CHD cohort and 66.4% of the ACS cohort were being treated with LLT. In both cohorts, low-density lipoprotein cholesterol (LDL-C) levels were lower for the treated than the non-treated patients; accordingly, a higher proportion of patients met the LDL-C goal of < 70 mg/dL (CHD: 28.1% vs. 0%, p = 0.10; ACS: 20.2% vs. 0%, p < 0.01). By the four-month follow-up, a higher proportion of the ACS patients that were originally not treated with LLT had met the LDL-C goal (from 0% to 54.5%), correlating with the increased use of medication. However, there was negligible improvement in the patients who were treated prior to the ACS.

CONCLUSION: Dyslipidaemia is a significant concern in Singapore, with few patients with stable or acute CHD meeting the recommended European Society of Cardiology/European Atherosclerosis Society goal. LLT was widely used but not optimised, indicating considerable scope for improved management of these very-high-risk patients.

* Title and MeSH Headings from MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.