Utilization of lipid-modifying therapy and low-density lipoprotein cholesterol goal attainment in patients at high and very-high cardiovascular risk: Real-world evidence from Germany.
Atherosclerosis
; 268: 99-107, 2018 01.
Article
in En
| MEDLINE
| ID: mdl-29197254
ABSTRACT
BACKGROUND AND AIMS:
Elevated low-density lipoprotein cholesterol (LDL-C) is a causal risk factor for cardiovascular (CV) events. European guidelines recommend reducing LDL-C as the primary lipid target to reduce CV risk, using lifestyle modifications and lipid-lowering therapy (LLT). Many European patients do not achieve guideline-recommended LDL-C levels. The present database analysis aimed to assess LLT treatment patterns and LDL-C threshold attainment in Germany in a large, real-world cohort of patients.METHODS:
Patients from the Cegedim Longitudinal Practice Database in Germany who met selection criteria were included (a) LDL-C measurement in 2013; (b) ≥20 years of age; (c) high or very-high CV risk conditions recent acute coronary syndrome (ACS), other coronary heart disease (CHD), ischemic stroke, peripheral arterial disease (PAD) (atherosclerotic cardiovascular disease [ASCVD]) or diabetes mellitus (DM) (non-ASCVD). LDL-C threshold attainment was assessed based on LDL-C targets from 2011 European guidelines.RESULTS:
42,767 patients met the inclusion criteria; 35% received current statin treatment, and 30% achieved guideline-recommended LDL-C targets. Attainment of LDL-C goals among ASCVD hierarchical categories was 46.7% for recent ACS, 35.8% for ischemic stroke, 34.9% for other CHD, and 26.9% for PAD. Among patients in the non-ASCVD group with DM, 23.6% achieved LDL-C goals. Similar results were observed when patients were grouped by prevalence (patients assigned to every risk group for which they qualified).CONCLUSIONS:
In this high/very-high CV risk population in Germany, statin utilization was low; suggesting that LLTs are not prescribed as per European guidelines. These results highlight the need to increase LLT use among high-risk patients.Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Practice Patterns, Physicians'
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Cardiovascular Diseases
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Hydroxymethylglutaryl-CoA Reductase Inhibitors
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Dyslipidemias
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Cholesterol, LDL
Type of study:
Diagnostic_studies
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Etiology_studies
/
Guideline
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Observational_studies
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Prevalence_studies
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Prognostic_studies
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Risk_factors_studies
Limits:
Aged
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Aged80
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Female
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Humans
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Male
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Middle aged
Country/Region as subject:
Europa
Language:
En
Journal:
Atherosclerosis
Year:
2018
Document type:
Article