The Lipid Treatment Assessment Project (L-TAP) - A multicenter survey to evaluate the percentages of dyslipidemic, patients receiving lipid-lowering therapy and achieving low-density lipoprotein cholesterol goals

Objective: To determine the percentage of patients in the multicenter Lipid Treatment Assessment Project receiving lipid-lowering therapy who are achi eving low-density lipoprotein cholesterol (LDL-C) goals as defined by Natio nal Cholesterol Education Program (NCEP) guidelines. Methods: Adult patients with dyslipidemia, who had been receiving the same lipid-lowering therapy for at least 3 months, were assessed at investigatio n sites. Lipid levels were determined once in each patient at the time of e nrollment. The primary end point was the success rate, defined as the propo rtion of patients who achieved their LDL-C target level as specified by NCE P guidelines. Results: 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 dis ease (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 C HD. Overall, only 38% of patients achieved NCEP-specified LDL-C target leve ls; success rates were 68% among low-risk patients, 37% among high-risk pat ents, and 18% among patients with CHD. Drug therapy was significantly (P le ss than or equal to.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. Conclusions: Large proportions of dyslipidemic patients receiving lipid-low ering therapy are not achieving NCEP LDL-C target levels. These findings in dicate that more aggressive treatment of dyslipidemia is needed to attain g oals established by NCEP guidelines.