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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.

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Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Italy. Electronic address:
IMS Health, London, UK.
Department of Internal Medicine and Medical Specialties, School of Medicine, University of Palermo, Italy.
Sanofi, Milan, Italy.
Sanofi, Bridgewater, NJ, USA.
Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA.
ANMCO Research Center, Florence, Italy.
Department of Pharmacological and Biomolecular Sciences, University of Milan and IRCCS Multimedica, Milan, Italy.



Statin utilization and lipid goal achievement were estimated in a large sample of Italian patients at high/very-high cardiovascular (CV) risk.


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.


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.


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.


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

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