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Published on: September 30, 2025

Low-Density Lipoprotein Cholesterol Goal Attainment in Indian Patients With Coronary Artery Disease: A Nationwide

Raman Puri1, Manish Bansal2, Kunal Mahajan3

  • 1Indraprastha Apollo Hospitals, New Delhi, India.

JACC. Asia
|June 30, 2026
PubMed

Insights

In India, achieving target low-density lipoprotein cholesterol (LDL-C) levels below 50 mg/dL for atherosclerotic cardiovascular disease (ASCVD) patients is challenging. Most patients on lipid-lowering therapy, even high-intensity statins, do not reach recommended LDL-C goals, indicating a need for improved treatment strategies.

Area of Science:

  • Cardiology
  • Public Health
  • Pharmacology

Background:

  • Premature atherosclerotic cardiovascular disease (ASCVD) is a significant health concern in India.
  • Population-level low-density lipoprotein cholesterol (LDL-C) levels are comparatively lower in India.
  • The Lipid Association of India recommends an LDL-C target <50 mg/dL for patients with established ASCVD.

Purpose of the Study:

  • To gather current data on LDL-C goal attainment in Indian patients diagnosed with ASCVD.
  • To assess the effectiveness of current lipid-lowering therapies in achieving target LDL-C levels in India.

Main Methods:

  • A large-scale study involving 115 cardiologists across India.
  • Recruitment of 10,417 patients with documented coronary artery disease on stable lipid-lowering therapy.
  • Inclusion of 9,658 patients with complete data, considering only directly measured LDL-C values.

Main Results:

  • The median treated LDL-C was 66.1 mg/dL, with only 27.0% of patients achieving the target of ≤50 mg/dL.
  • High-intensity statin therapy was utilized by 73.0% of patients.
  • Combination therapy was used in 12.0% of patients, and treatment intensification was observed in only 37.3% of those above the LDL-C target.

Conclusions:

  • A significant gap exists in LDL-C control for secondary ASCVD prevention in India.
  • Less than a quarter of patients achieved target LDL-C levels despite high-intensity statin use.
  • Underutilization of combination therapy and clinician inertia in treatment intensification are critical issues requiring immediate attention to enhance patient outcomes.
Abstract

Keywords:
Lipid Association of Indiabempedoic acidevolocumabezetimibeinclisiranlipid-lowering therapy

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