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Adherence to Current Dyslipidemia Guideline in Patients Utilizing Statins According to Risk Groups and Gender
Taner Şen1, Lale Dinç Asarcıklı2, Saadet Güven3
1Department of Cardiology, Faculty of Medicine, Kütahya Health Sciences University, Kütahya, Türkiye.
Insights
Adherence to dyslipidemia guidelines is low, with only 26.2% of statin-treated patients reaching target LDL-C levels. Physician inertia and the need for combination therapy are key factors in achieving lipid goals.
Area of Science:
- Cardiology
- Lipidology
- Clinical Practice Guidelines
Background:
- Assessing adherence to European Society of Cardiology (ESC) dyslipidemia guidelines.
- Evaluating achievement of target lipid values across different cardiovascular risk groups.
- Identifying reasons for failing to reach low-density lipoprotein-cholesterol (LDL-C) goals in patients on statin therapy.
Purpose of the Study:
- To evaluate the adherence to current European Society of Cardiology dyslipidemia guidelines.
- To determine the proportion of patients achieving target LDL-C levels based on their risk stratification.
- To identify the primary reasons for suboptimal LDL-C control in cardiology outpatients on statin treatment.
Main Methods:
- The AIZANOI study employed a multi-center, cross-sectional observational design.
- Data were collected from 9 cardiology centers between August 1, 2021, and November 1, 2021.
- Included 1225 patients on statin therapy for at least 3 months.
Main Results:
- Only 26.2% of patients achieved their target LDL-C levels.
- Despite high-intensity statin use in 58.4% of very high-risk and 44.4% of high-risk patients, guideline-recommended LDL-C levels were met by only 24.5% and 34.9%, respectively.
- Physician preference, or physician inertia, was the most common reason (40.3%) for not using target-dose statins.
Conclusions:
- A low percentage (26.2%) of cardiology outpatients on statin therapy achieve guideline-recommended LDL-C targets.
- Physician inertia significantly contributes to suboptimal lipid management.
- Combination therapy is likely necessary for the majority of patients to reach LDL-C goals.
Background:
The aim of this study was to assess the adherence to the current European Society of Cardiology dyslipidemia guidelines, the ratio of reaching target values according to risk groups, and the reasons for not reaching LDL-cholesterol (LDL-C) goals in patients on already statin therapy in a cardiology outpatient population.
Methods:
The AIZANOI study is a multi-center, cross-sectional observational study including conducted in 9 cardiology centers between August 1, 2021, and November 1, 2021.
Results:
A total of 1225 patients (mean age 62 ± 11 years, 366 female) who were already on statin therapy for at least 3 months were included. More than half (58.2%) of the patients were using high-intensity statin regimens. Only 26.2% of patients had target LDL-C level according to their risk score. Despite 58.4% of very high-risk patients and 44.4% of high-risk patients have been using a high-intensity statin regimen, only 24.5% of very-high-risk patients and only 34.9% of high-risk patients have reached guideline-recommended LDL-C levels. Most prevalent reason for not using target dose statin was physician preference (physician inertia) (40.3%).
Conclusion:
The AIZANOI study showed that we achieved a target LDL-C level in only 26.2% of patients using statin therapy. Although 58.4% of patients with a very high SCORE risk and 44.4% of patients with a high SCORE risk were using a target dose statin regimen, we were only able to achieve guideline-recommended LDL-C levels in 24.5% and 34.9% of them, respectively, in cardiology outpatients clinics. Physician inertia is one of the major factors in non-adherence to guidelines. These findings highlight that combination therapy is needed in most of the patients.
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