Skip To Main Content

Importance of lipid registries in cardiovascular prevention

Key Takeaway

In clinical practice, there exist a gap between lipid guidelines and lipid management - use of combination therapy and improving patient adherence should be prioritized

  • Only half of the patients with CVD received high-intensity statins
  • Less than half attained the LDL-C goal in secondary prevention

Major reasons for insufficient therapy:

  • Side effects of LLT
  • Poor adherence to medication regimens
  • Low use of combination therapies by physicians

Why This Matters

  • Extrapolating data from clinical trials of specifically selected populations to usual care in clinical practice is limited.
  • Lipid registry-based research is an important tool for evaluating current lipid management in patients at risk of CVD.

Key Highlights

Various clinical guidelines recommend LLTs for ASCVD prevention

  • CV event risk remains in high-risk patients with multiple risk factors/established ASCVD
  • It is important to quantify accurately if these high-risk patients are receiving guideline-recommended LLTs and attaining optimal recommended LDL-C levels in routine clinicalpractice.

Occurrence of ASCVD events§ was assessed between hospital discharge for each patient’s index AMIand their first fill for a PCSK9i.

Registries of
Lipid management
Study Findings
Euroaspire v
  • 8,261 patients with verified coronary artery events or interventions
  • Only half of the patients were prescribed high-intensity lipid-lowering drugs
  • Only 8% were prescribed a combination of ezetimibe and statins
Da Vinci
  • 2,039 patients with established ASCVD
  • 42% of patients used high-intensity statins
  • < 10% patients used ezetimibe or PCSK9 inhibitors in combination with moderate- or high-intensity statins
Dysis II
  • 10,661 patients with either stable coronary heart disease or ACS
  • Less than a third of the patients had an LDL-C level<70 mg/dL
  • Intensity of LLT was moderate although all patients were at very high risk
Gould
  • 5,006 patients with ASCVD
  • Median LDL-C level was 90 mg/dL for 2 years
  • Only about 40% of secondary prevention patients received high-intensity statins
  • Non-statin LDL-C lowering therapies were 10%
Palm
  • 5,006 patients with ASCVD
  • 70% patients had LDL-C levels ≥70 mg/dL at the time of enrollment
  • Over half of the secondary prevention patients had either no statin or under-dosed statin

Barriers to lipid management

Majority of secondary patients receive inadequate LLT

  • Guideline-recommended LDL-C goal is not achieved with monotherapy,especially in high-risk patients

Data highlight the importance of combination therapies and intensive LLT regimens including greater utilization of non-statin LLTs

Poor adherence of both patients and physicians to LLTs is associated with increased variability in LDL-C levels

  • Non-statin LLTs (ezetimibe/PCSK9 inhibitor) may be useful for these issues

Tailored interventions*based on each patient’s requirements are important

*Such as optimal treatment, simple regimen, education, regular monitoring, and feedback during their treatments

Abbreviations

Reference

MAT-KW-2200160/v2/Jan 2024