Background: Cardiovascular disease is a growing problem throughout the world. As one of the most significant contributors to the development and progression of this disease, hyperlipidemia is a primary target for improving outcome for these patients. The extent of lipid abnormalities in patients with coronary heart disease (CHD) or those suffering an acute coronary syndrome (ACS), and the strategies used to treat them have not been systematically investigated in Jordan and Lebanon.

Methods: The second Dyslipidemia International Study (DYSIS II) is an observational study established to quantify hyperlipidemia and its treatment throughout the world. Patients were enrolled if they had stable CHD or were being hospitalized due to an ACS. Data regarding cardiovascular risk factors, comorbidity, lipid levels, and lipid-lowering therapy (LLT) were collected.

Results: A total of 360 patients were enrolled across Jordan and Lebanon; 238 with stable CHD & 122 with an ACS.Few LLT-treated patients had a low-density lipoprotein cholesterol (LDL-C) level below the 70 mg/dl guide- line-recommended target for very high-risk patients (28.3% of CHD patients; 27.1% of ACS patients).The mean atorvastatin- equivalent daily statin dosage was 29 ± 19 mg for the treated subjects with stable CHD and 24 ± 19 mg for those with an ACS. At the 4-month follow-up, statin use had increased significantly, but dosages remained inadequately low.

Conclusions: CHD and ACS patients in Jordan and Lebanon display extensive hyperlipidemia. Use of LLT is widespread, but the low proportion of subjects achieving the recommended LDL-C target suggests that it is not being optimally employed.

Keywords: dyslipidemia; hypercholesterolemia; statins; coronary heart disease; acute coronary syndrome

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