6533b82afe1ef96bd128c169

RESEARCH PRODUCT

Statin utilization and lipid goal attainment in high or very-high cardiovascular risk patients: insights from Italian general practice

Marcello ArcaMaurizio AvernaŞErban R. IorgaDavid AnsellAldo P. MaggioniGeorges PaizisKatherine GorcycaFrancesca FanelliRadovan TomicAlberico L. Catapano

subject

MaleTime FactorsSettore MED/09 - Medicina InternaDatabases FactualGeneral PracticeFamilial hypercholesterolemiaDisease030204 cardiovascular system & hematology0302 clinical medicineRisk FactorsCardiovascular disease; Low-density lipoprotein cholesterol; Non-high-density lipoprotein cholesterol; Prevention; StatinMedicine030212 general & internal medicinePractice Patterns Physicians'StrokeAged 80 and overLipid MeasurementMiddle AgedCardiovascular diseaseNon-high-density lipoprotein cholesterolCholesterolTreatment OutcomeItalyCardiovascular DiseasesCohortPractice Guidelines as Topiclipids (amino acids peptides and proteins)FemaleGuideline AdherenceCardiology and Cardiovascular Medicinemedicine.medical_specialtyAcute coronary syndromeStatinCardiovascular disease; Low-density lipoprotein cholesterol; Non-high-density lipoprotein cholesterol; Prevention; Statin; Cardiology and Cardiovascular Medicinemedicine.drug_classRisk Assessment03 medical and health sciencesDiabetes mellitusInternal medicineHumansLow-density lipoprotein cholesterolAgedDyslipidemiasRetrospective Studiesbusiness.industryPreventionStatinCholesterol LDLmedicine.diseaseHydroxymethylglutaryl-CoA Reductase InhibitorsbusinessBiomarkers

description

Background and aims: Statin utilization and lipid goal achievement were estimated in a large sample of Italian patients at high/very-high cardiovascular (CV) risk. Methods: Patients aged ≥18 years with a valid low-density lipoprotein cholesterol (LDL-C) measurement in 2015 were selected from the IMS Health Real World Data database; non-high-density lipoprotein cholesterol (non-HDL-C) was assessed in those with available total cholesterol measurements. Index dates were defined as the last valid lipid measurement in 2015. Patients were hierarchically classified into mutually exclusive risk categories: heterozygous familial hypercholesterolemia (primary and secondary prevention), atherosclerotic CV disease (including recent acute coronary syndrome [ACS], chronic coronary heart disease, stroke, and peripheral arterial disease), and diabetes mellitus (DM) alone. Statin and non-statin lipid-modifying therapy (LMT) use, and European Society of Cardiology (ESC)/European Atherosclerosis Society (EAS) guideline-recommended goal attainment, were assessed. Results: Among 66,158 patients meeting selection criteria, the overall rate of LMT prescriptions was 53.3%, including 7.7% on high-intensity statin therapy. Statin use was highest for recent ACS and lowest for DM alone. LDL-C goal attainment was 16.0% for <1.8 mmol/l and 45.0% for <2.5 mmol/l; 24.3% reached non-HDL-C <2.6 mmol/l and 52.2% were at <3.3 mmol/l. Goal achievement was greatest with high-intensity statin use. Conclusions: Statin use in this cohort was consistent with previous reports in Italian patients at high/very-high CV risk, and low relative to statin use in other European countries. The low rate of ESC/EAS lipid goal attainment observed was consistent with outcomes of other European studies.

yearjournalcountryeditionlanguage
2018-01-01
10.1016/j.atherosclerosis.2018.02.024http://hdl.handle.net/11573/1195110