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Atherosclerosis. 2018 Apr;271:120-127. doi: 10.1016/j.atherosclerosis.2018.02.024. Epub 2018 Feb 17.

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

Author information

1
Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy. Electronic address: marcello.arca@uniroma1.it.
2
IMS Health, London, UK.
3
Department of Internal Medicine and Medical Specialties, School of Medicine, University of Palermo, Italy.
4
Sanofi, Milan, Italy.
5
Sanofi, Bridgewater, NJ, USA.
6
Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA.
7
ANMCO Research Center, Florence, Italy.
8
Department of Pharmacological and Biomolecular Sciences, University of Milan and IRCCS Multimedica, Milan, Italy.

Abstract

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.

KEYWORDS:

Cardiovascular disease; Low-density lipoprotein cholesterol; Non-high-density lipoprotein cholesterol; Prevention; Statin

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