3ST-POL trial: standards of statin use in Poland in the context of the European Society of Cardiology guidelines

INTRODUCTION: Statins play a crucial role in modern cardiological pharmacotherapy. For the patient, as the beneficiary of an effective pharmacotherapy, it is of utmost importance that his or her physician can take maximum advantage of the whole potential of the available medications. OBJECTIVES: The aim of the study was to analyse the effectiveness of statin treatment in Polish patients treated in an ambulatory setting, in view of the European Society of Cardiology guidelines. PATIENTS AND METHODS: The study was conducted on 49,950 ambulatory patients from Poland (women – 53%, men – 47%). The questionnaire consisted of 43 questions and was completed by a physician based on the results of physical examination, medical records, lipid profile, and additional tests. Twenty-eight per cent of the patients were obese, 37% were overweight, and more than 26% were smokers. The mean blood pressure was 142.9/84.0 mmHg (±18.5/11.6 mmHg). The target objectives of the pharmacological treatment of arterial hypertension were achieved in less than 25% of the study population. Nearly 50% of the patients had coronary artery disease, 20% had myocardial infarction, and 10% had transient ischemic attack or cerebral stroke. More than 30% of the patients had diabetes mellitus. RESULTS: The most commonly used statins were atorvastatin and simvastatin (49.1% vs. 44.8%, respectively; P <0.05). Almost 71% of the patients received the daily statin dose of <20 mg. Mean total cholesterol (TC) was 244.9 mg/dl, low-density lipoprotein (LDL) cholesterol – 155 mg/dl, and triglycerides – 180 mg/dl. TC levels of <190 mg/dl were achieved in 1 in 6 patients, and LDL levels of <115 mg/dl in less than 21% of the patients. CONCLUSIONS: Despite the recommendation to administer statins at higher than minimum doses in primary and secondary prevention of coronary heart disease, this drug class is still underestimated by general practitioners.