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Correlates of LDL-cholesterol goal attainment in patients under lipid lowering therapy

Laurent Laforest1, Philippe Moulin, Thierry Souchet

  • 1CHU Lyon, Unité de Pharmacoépidémiologie, Service Neurologie, Hopital Pierre, Wertheimer, Bron F-69677, France.

Atherosclerosis
|January 15, 2008
PubMed

Insights

Many high-risk patients fail to reach LDL-cholesterol goals on lipid-lowering therapy. Drug choice significantly impacts achieving therapeutic objectives, with some statins and fibrates showing lower efficacy.

Area of Science:

  • Cardiology
  • Pharmacology
  • Public Health

Background:

  • Lipid-lowering therapy (LLT) is crucial for managing cardiovascular risk, yet achieving therapeutic objectives for low-density lipoprotein cholesterol (LDL-C) remains a significant challenge.
  • Correlates of successful LDL-C goal attainment in real-world observational settings are not well-understood.

Purpose of the Study:

  • To investigate the attainment of LDL-cholesterol therapeutic objectives in patients undergoing LLT managed by general practitioners.
  • To explore the association between different lipid-lowering medications and the achievement of LDL-C goals.

Main Methods:

  • Observational study including 2727 patients managed by general practitioners on LLT.
  • LDL-C therapeutic objective defined based on the number of cardiovascular risk factors (AFSSAPS-2005 guidelines).
  • Statistical analysis to compare therapeutic objective attainment across various lipid-lowering drugs.

Main Results:

  • 58.5% of high cardiovascular risk patients did not achieve their LDL-C therapeutic objective.
  • Fibrates, fluvastatin, and pravastatin were associated with lower odds of reaching therapeutic objectives compared to simvastatin.
  • Atorvastatin and rosuvastatin did not show significant differences in goal attainment compared to simvastatin at prescribed doses.

Conclusions:

  • Real-world LLT use shows inadequate LDL-C therapeutic objective attainment in high-risk patients.
  • Significant differences in therapeutic objective attainment exist between lipid-lowering drugs at doses prescribed by general practitioners.
Abstract

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