Comparison of Serum Lipid Management According to Japan Atherosclerosis Society 2007 and 2012 Guidelines: Analysis of Data from Ningen Dock Database

抄録

Objective: The Japan Atherosclerosis Society (JAS) recommended that serum lipid management goals based on a coronary heart disease (CHD) risk factor classification be included in its 2007 guidelines (GL 2007) for the diagnosis and prevention of atherosclerotic cardiovascular disease in the Japanese population, which were revised in 2012 (GL 2012). Using the Japan Society of Ningen Dock database, we compared the distributions of the risk categories according to GL 2007 and GL 2012.

Methods: A total of 17,991 adults taking dyslipidemia medications were enrolled. The JAS GL 2007 and GL 2012 were used for evaluation. The guidelines have 2 different objectives (secondary prevention for subjects with a prior history of CHD and primary prevention for those with other CHD risk factors) and we compared the distributions of risk categories in a primary prevention group. Serum low-density lipoprotein cholesterol (LDL-C) levels were calculated using the Friedewald formula.

Results: Of the patients in Category I according to GL 2007, 6.6% came under Category III according to GL 2012. Of the patients in Category II according to GL 2007, 37.1%, 38.5%, and 24.3% came under Categories I, II, and III according to GL 2012, respectively. Most subjects (81.1%) in Category III according to GL 2007 were still in the same category according to GL 2012, while 4.3% and 14.7% were in Categories I and II, respectively.

Conclusion: According to GL 2012, 43.7% of the primary prevention patients were assigned to categories different from those based on GL 2007.