Goal Attainment Rate in Secondary Prevention in Taiwan - A Chang Gung Research Database Study

Effective lipid control is essential in the secondary prevention of cardiovascular disease to reduce recurrent events. However, the low-density lipoprotein cholesterol (LDL-C) goal attainment rates among high-risk patients in Taiwan remain unclear.

This study aimed to evaluate LDL-C goal attainment and adherence to lipid-lowering therapy (LLT) in Taiwanese patients with atherosclerotic cardiovascular disease (ASCVD) using data from the Chang Gung Research Database.

We conducted a retrospective observational study of 116,228 ASCVD patients treated between 2017 and 2021. LDL-C levels, LLT intensity, and goal attainment (< 70 mg/dL) were analyzed. Multivariate logistic regression was used to identify factors associated with LDL-C goal attainment.

The mean age of the patients was 67.4 years, and 63.8% were male. Coronary artery disease (CAD) comprised 57.3% of the diagnoses. At baseline, 12.2% of the patients achieved LDL-C < 70 mg/dL, improving to 25.1% at 12 months. High-intensity LLT was associated with a significantly higher likelihood of goal attainment (relative risk 1.54, p < 0.001). Male sex, diabetes mellitus, and prior percutaneous coronary intervention were positively correlated with LDL-C goal attainment. Despite treatment, LDL-C control remained suboptimal, particularly in cerebrovascular disease and peripheral artery disease subgroups.

Real-world LDL-C goal attainment among Taiwanese ASCVD patients is low, underscoring the need for intensified lipid management and improved adherence to guideline-based therapy. Tailored interventions are especially warranted for non-CAD ASCVD patients to reduce cardiovascular risk.