Risk factors affecting the failed low-density lipoprotein level achievement rate in working-age male population at...

Area of Science:

• Cardiovascular Medicine
• Pharmacoeconomics
• Public Health

Background:

• Secondary prevention of cardiovascular events often involves statins and anti-platelet agents.
• Achieving target low-density lipoprotein cholesterol (LDL-C) levels is critical for reducing cardiovascular risk.
• Factors influencing LDL-C goal attainment in real-world clinical practice require further investigation.

Purpose of the Study:

• To determine the rate of LDL-C achievement in patients treated with statins and anti-platelet agents.
• To identify factors associated with failure to achieve LDL-C goals in this patient population.
• To analyze data from a large Japanese insurance claims and health check-up database.

Main Methods:

• A retrospective cohort study design was employed using Japanese health insurance claims and health check-up data.
• Working-age male patients initiating statin and anti-platelet therapy for secondary cardiovascular prevention were identified.
• LDL-C levels, adherence (proportion of days covered - PDC), and baseline characteristics were assessed over a 3-year period.

Main Results:

• The study included 294 working-age males (mean age 47.8 years).
• Consecutive LDL-C achievement rates (<100 mg/dL) over three years were 49.7%, 51.4%, and 45.9%.
• Lower statin adherence (PDC) and higher baseline LDL-C levels were significantly associated with failed LDL-C achievement.

Conclusions:

• Statin adherence is a key modifiable factor for achieving LDL-C targets in working-age males undergoing secondary cardiovascular prevention.
• Patients with higher baseline LDL-C require particular attention to ensure optimal adherence and treatment efficacy.
• These findings highlight the need for interventions to improve medication adherence in this demographic to enhance cardiovascular risk reduction.