Use of Lipid-modifying Therapy and LDL-C Goal Attainment in a High-Cardiovascular-Risk Population in the Netherlands

Abstract

LMT use among high-cardiovascular-risk patients was modest, which contributed to 46% of the cohort failing to reach LDL-C goals <100 mg/dL. Underuse and suboptimal use of LMTs in this cohort represent opportunities for quality improvement programs aimed at reducing the risk of cardiovascular events.

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

“…Although previous studies have looked at LLT utilization and goal attainment in European patients, the present study aimed to provide critical updates to extend the literature by providing recent estimates of LLT use and lipid goal attainment in Germany. The findings from this study are consistent with earlier studies on LLT utilization and poor goal attainment in patients considered at high risk of CV events [10,11,20]. A recent analysis of the international DYSIS study showed that only 26.8% of patients attained their riskbased target LDL-C level, and of the 76% of patients classified as being at very-high risk, only 21.7% attained their LDL-C goal [26].…”

“…Despite the discordance with the 2011 EAS/ESC guidelines, our results are similar to those observed in other studies [10,11,20]. An analysis from the DYSIS study comparing LDL-C goal achievement in patients enrolled in Germany versus patients in the UK found that patients in Germany received high-intensity statins less often than UK patients.…”

“…Despite the safety and tolerability of statins being well established [6], appropriate statin use and LDL-C reduction may remain suboptimal within clinical practice in Europe. A study in the Netherlands found that lipid-lowering therapy (LLT) was used in 67% of patients at high CV risk, and overall, 55% of patients achieved an LDL-C goal <2.6 mmol/L (<100 mg/dL) [10]. Similarly, among >180,000 high CV risk patients in the UK in 2014, 79% and 62% of ASCVD and non-ASCVD received statins, but only 31% and 26%, respectively, reached the LDL-C goal of <1.8 mmol/L (70 mg/ dL) [11].…”

Low-density lipoprotein cholesterol goal attainment rates in high-risk patients with cardiovascular diseases and diabetes mellitus in Korea: a retrospective cohort study

“…Comparable results (for 2010) in this study showed LDL-C goal attainment rates of approximately 12 and 32%, in DM patients with or without additional high-risk disease, respectively. Low rates of LDL-C goal attainment have also been described consistently in other countries, including 58% of recent ACS patients in the Netherlands [38], 28.8% of ACS survivors in Hong Kong and Taiwan [39], 30% of German atherosclerotic CVD patients [40], 41% of patients with DM at very-high cardiovascular risk receiving statins in France [41] and 38% of DM patients with ischemic heart disease in a tertiary hospital in China [42]. In contrast, a higher attainment rate (68%) for Japan Atherosclerosis Society guideline-recommended LDL-C targets [43] was reported in high-risk patients for CVD in Japan [44].…”

A Retrospective Study of LDL-Cholesterol in Koreans on Atorvastatin/Ezetimibe or Atorvastatin Monotherapy

“…Data from the international, observational, cross-sectional DYSIS II study showed that fewer than onethird of patients with stable CHD achieved an LDL-C level <70 mg/dL, despite all patients being at very high CV risk [21], and these findings were replicated within Asian DYSIS II cohorts [8,9,22]. Other cross-sectional and real-world evidence clearly demonstrates that many CHD patients with dyslipidemia remain inadequately treated with most patients on statin therapy not achieving treatment targets [23][24][25][26][27][28]. Collectively, these findings indicate huge potential to improve cardiovascular outcomes using more intensive lipid-lowering therapy.…”