Prevalence of the American College of Cardiology/American Heart Association statin eligibility groups, statin use, and low-density lipoprotein cholesterol control in US adults using the National Health and Nutrition Examination Survey 2011–2012

Wong, Nathan D.; Young, Daphnee; Zhao, Yanglu; Nguyen, Huy; Caballes, Jared; Khan, Irfan; Sanchez, Robert J.

doi:10.1016/j.jacl.2016.06.011

Cited by 72 publications

(62 citation statements)

References 25 publications

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“…The underutilization of high-intensity statins in high-risk patients with ASCVD in the United States is a major reason as to why up to 80% of high-risk patients are unable to achieve their LDL-C goal. [2][3][4] High-risk patients who are unable to maintain use of moderate or high-intensity statin, or who are unable to achieve their LDL-C target goal, are at increased risk of recurrent myocardial infarction and coronary heart disease events compared with those demonstrating high adherence to moderate-or high-intensity statin regimens who reach their LDL-C goals. 3,11 Of patients who were eligible for add-on therapy to lower their LDL-C levels according to current guidelines, only 4% were prescribed ezetimibe and even fewer (<0.5%) were prescribed a PCSK9 inhibitor.…”

Section: Discussionmentioning

confidence: 99%

“…High-risk patients not achieving their recommended lowdensity lipoprotein cholesterol (LDL-C) goals despite the availability of statin therapy remain at high residual cardiovascular risk. [1][2][3][4][5] In recognition of this, the American College of Cardiology (ACC) published their first Expert Consensus Decision Pathway (ECDP) in 2016, describing the role of nonstatin therapies for LDL-C lowering in the management of atherosclerotic cardiovascular disease (ASCVD) risk. 6 In the nonstatin therapy options, 6 proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors have demonstrated efficacy and safety in randomized controlled trials in a range of high-risk patients, 7 and also a reduction of the risk of cardiovascular events.…”

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confidence: 99%

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Prescribing Patterns of Proprotein Convertase Subtilisin-Kexin Type 9 Inhibitors in Eligible Patients With Clinical Atherosclerotic Cardiovascular Disease or Heterozygous Familial Hypercholesterolemia

Karalis

Mallya

Ghannam

et al. 2018

The American Journal of Cardiology

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Two proprotein convertase subtilisin-kexin type 9 (PCSK9) inhibitors are approved for patients with atherosclerotic cardiovascular disease or heterozygous familial hypercholesterolemia who require additional low-density lipoprotein cholesterol (LDL-C) lowering. This retrospective study sought to determine differences between eligible patients who were prescribed and those who were not prescribed a PCSK9 inhibitor. Patients from an electronic medical record database were included in the analysis, and their demographic, clinical, and treatment characteristics were evaluated. Of 368,624 PCSK9 inhibitor-eligible patients, 1,752 (<0.5%) received a PCSK9 inhibitor prescription. Patients who received a PCSK9 inhibitor were more frequently associated with a higher cardiovascular disease risk category and a higher baseline LDL-C level (139.4 vs 103.5 mg/dl; p <0.0001) compared with those who did not. Patients with a PCSK9 inhibitor prescription were significantly more likely to be on ezetimibe, alone or in combination with a statin, at baseline compared with those without (29% vs 5%; p <0.0001). The use of a PCSK9 inhibitor was very low in the 2 groups of patients identified as PCSK9 inhibitor-eligible based on the American College of Cardiology Expert Consensus Decision Pathway. In conclusion, this study demonstrates that most PCSK9 inhibitor-eligible patients do not receive a PCSK9 inhibitor prescription, highlighting that many high-risk patients could benefit from additional LDL-C lowering with a PCSK9 inhibitor.

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Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

Prescribing Patterns of Proprotein Convertase Subtilisin-Kexin Type 9 Inhibitors in Eligible Patients With Clinical Atherosclerotic Cardiovascular Disease or Heterozygous Familial Hypercholesterolemia

Karalis

Mallya

Ghannam

et al. 2018

The American Journal of Cardiology

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“…As such they are prescribed for individuals with high cholesterol who have had or are at risk for atherosclerotic cardiovascular disease. Statins have become one of the most widely used drugs in the United States and some other parts of the world . According to the National Health and Nutrition Examination Survey from 2011 to 2012, an estimated 38.6 million Americans were using a statin …”

Section: Introductionmentioning

confidence: 99%

Statin therapy and association with ovarian cancer risk in the New England Case Control (NEC) study

Akinwunmi

Vitonis

Titus

et al. 2018

Intl Journal of Cancer

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Statins are widely used to lower blood cholesterol and reduce risk for cardiovascular diseases, but attention has recently focused on a role in cancer prevention or therapy. Here we present data from a large case-control study addressing whether statin use can lower the risk for epithelial ovarian cancer (EOC). Between 1992 and 2008, data including medications used for at least 6 months were collected from 2,040 cases with EOC and 2,100 frequency-matched controls without the disease who participated in the New England Case Control study. We used unconditional logistic regression controlling for matching factors and potential confounders to examine the association between statin use and the risk for EOC. Overall, women who used statins had 32% lower risk of ovarian cancer compared to non-users (Odds ratio (OR) 0.68, 95% Confidence Interval (CI): 0.54-0.85), adjusting for the matching factors and other covariates. The reduced risk was most apparent in women taking a lipophilic statin who began use after age 49, and who had used them 2-4.9 years. Statin use was associated with lower risks for both serous and non-serous histologic subtypes with the strongest effect seen for mucinous and mixed epithelial subtypes. The association became apparent about a decade after the introduction of statins and did not appear to be confounded by indications for use of statins or medications used concomitantly. In this case-control study, statins were found to lower the risk for both serous and non-serous EOC and especially mucinous EOC.

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“…Significant reductions in cardiovascular events have been observed in individuals with DM treated with statins [13]. However, real-world studies often report under-utilisation of statins and sub-optimal dosing in high-risk patients [14, 15]. Additional lipid-lowering therapies are used in conjunction with statins to address mixed dyslipidaemia, including ezetimibe, fibrates, nicotinic acid and omega-3 fatty acids.…”

Section: Introductionmentioning

confidence: 99%

Design and rationale of the ODYSSEY DM-DYSLIPIDEMIA trial: lipid-lowering efficacy and safety of alirocumab in individuals with type 2 diabetes and mixed dyslipidaemia at high cardiovascular risk

Müller‐Wieland

Leiter

Cariou

et al. 2017

Cardiovasc Diabetol

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BackgroundType 2 diabetes mellitus (T2DM) is often associated with mixed dyslipidaemia, where non-high-density lipoprotein cholesterol (non-HDL-C) levels may more closely align with cardiovascular risk than low-density lipoprotein cholesterol (LDL-C). We describe the design and rationale of the ODYSSEY DM-DYSLIPIDEMIA study that assesses the efficacy and safety of alirocumab, a proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor, versus lipid-lowering usual care in individuals with T2DM and mixed dyslipidaemia at high cardiovascular risk with non-HDL-C inadequately controlled despite maximally tolerated statin therapy. For the first time, atherogenic cholesterol-lowering with a PCSK9 inhibitor will be assessed with non-HDL-C as the primary endpoint with usual care as the comparator.MethodsDM-DYSLIPIDEMIA is a Phase 3b/4, randomised, open-label, parallel group, multinational study that planned to enrol 420 individuals. Main inclusion criteria were T2DM and mixed dyslipidaemia (non-HDL-C ≥100 mg/dl [≥2.59 mmol/l], and triglycerides ≥150 and <500 mg/dl [≥1.70 and <5.65 mmol/l]) with documented atherosclerotic cardiovascular disease or ≥1 additional cardiovascular risk factor. Participants were randomised (2:1) to alirocumab 75 mg every 2 weeks (Q2W) or lipid-lowering usual care on top of maximally tolerated statin (or no statin if intolerant). If randomised to usual care, investigators were able to add their pre-specified choice of one of the following to the patient’s current statin regimen: ezetimibe, fenofibrate, omega-3 fatty acids or nicotinic acid, in accordance with local standard-of-care. Alirocumab-treated individuals with non-HDL-C ≥100 mg/dl at week 8 will undergo a blinded dose increase to 150 mg Q2W at week 12. The primary efficacy endpoint is non-HDL-C change from baseline to week 24 with alirocumab versus usual care; other lipid levels (including LDL-C), glycaemia-related measures, safety and tolerability will also be assessed. Alirocumab will be compared to fenofibrate in a secondary analysis.ResultsRecruitment completed with 413 individuals randomised in 14 countries worldwide. Results of this trial are expected in the second quarter of 2017.ConclusionsODYSSEY DM-DYSLIPIDEMIA will provide information on the efficacy and safety of alirocumab versus lipid-lowering usual care in individuals with T2DM and mixed dyslipidaemia at high cardiovascular risk using non-HDL-C as the primary efficacy endpoint. Trial registration NCT02642159 (registered December 24, 2015)Electronic supplementary materialThe online version of this article (doi:10.1186/s12933-017-0552-4) contains supplementary material, which is available to authorized users.

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Prevalence of the American College of Cardiology/American Heart Association statin eligibility groups, statin use, and low-density lipoprotein cholesterol control in US adults using the National Health and Nutrition Examination Survey 2011–2012

Cited by 72 publications

References 25 publications

Prescribing Patterns of Proprotein Convertase Subtilisin-Kexin Type 9 Inhibitors in Eligible Patients With Clinical Atherosclerotic Cardiovascular Disease or Heterozygous Familial Hypercholesterolemia

Prescribing Patterns of Proprotein Convertase Subtilisin-Kexin Type 9 Inhibitors in Eligible Patients With Clinical Atherosclerotic Cardiovascular Disease or Heterozygous Familial Hypercholesterolemia

Statin therapy and association with ovarian cancer risk in the New England Case Control (NEC) study

Design and rationale of the ODYSSEY DM-DYSLIPIDEMIA trial: lipid-lowering efficacy and safety of alirocumab in individuals with type 2 diabetes and mixed dyslipidaemia at high cardiovascular risk

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