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Treatment patterns and low-density lipoprotein cholesterol (LDL-C) goal attainment among patients receiving high- or

Kathleen M Fox1, Ming-Hui Tai2, Karel Kostev3

  • 1Strategic Healthcare Solutions LLC, Aiken, SC, USA.

Clinical Research in Cardiology : Official Journal of the German Cardiac Society
|December 24, 2017
PubMed

Insights

Most patients with atherosclerotic cardiovascular disease (ASCVD) on statins do not reach their LDL-C goal of <70 mg/dL. Despite this, treatment regimens rarely change in routine care.

Area of Science:

  • Cardiology
  • Pharmacology
  • Public Health

Background:

  • European guidelines recommend a low-density lipoprotein cholesterol (LDL-C) goal of <70 mg/dL for patients with atherosclerotic cardiovascular disease (ASCVD).
  • Previous studies indicate low rates of achieving LDL-C goals in real-world settings.
  • Statin utilization and its impact on goal attainment require further investigation in routine care.

Purpose of the Study:

  • To assess LDL-C goal attainment (<70 mg/dL) in ASCVD patients using moderate- or high-intensity statins.
  • To describe LDL-C goal attainment across different statin utilization patterns in routine care.
  • To analyze treatment pattern changes in relation to LDL-C goal attainment.

Main Methods:

  • Retrospective cohort study using electronic medical records from QuintilesIMS® Disease Analyzer in Germany.
  • Identified ASCVD patients on moderate- or high-intensity statins between 2012-2014.
  • Assessed LDL-C goal attainment using the lowest LDL-C value and analyzed treatment patterns (no change, switch, titration, discontinuation) over at least one year of follow-up.

Main Results:

  • In over 14,000 patients annually (mean age 71, 35% female), approximately 80% had LDL-C ≥70 mg/dL.
  • Only 11-24% of patients achieved LDL-C goal attainment, varying by treatment pattern.
  • Despite low goal attainment, most patients (79-81%) had no change in statin regimen; 14-16% discontinued statins.

Conclusions:

  • A majority of ASCVD patients on moderate- or high-intensity statins do not achieve the recommended LDL-C goal of <70 mg/dL.
  • Treatment regimens for ASCVD patients are infrequently modified, even when LDL-C goals are not met.
  • This highlights a potential gap in optimizing lipid-lowering therapy in routine clinical practice.
Abstract

Keywords:
Cardiovascular diseaseHyperlipidemiaLDL-CLDL-C goal attainmentStatin

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