Use of Lipid-Lowering Medications and the Likelihood of Achieving Optimal LDL-Cholesterol Goals in Coronary Artery Disease Patients

Author:

Karalis Dean G.12ORCID,Victor Brett2,Ahedor Lilian2ORCID,Liu Longjian3

Affiliation:

1. Cardiology Consultants of Philadelphia, Philadelphia, PA 19107, USA

2. Division of Cardiology, Drexel University College of Medicine, Philadelphia, PA 19107, USA

3. Department of Epidemiology and Biostatistics, Drexel University School of Public Health, Philadelphia, PA 19107, USA

Abstract

Background. In clinical practice, most coronary artery disease patients are not achieving their recommend LDL-cholesterol goal of <70 mg/dL. Methods. We conducted a retrospective analysis of outpatient electronic health records and the most recent lipid profile, lipid-lowering medications and doses were collected. Results. We identified 9950 coronary artery disease patients. Only 37% on a statin alone achieved an LDL-cholesterol of <70 mg/dL, and most were on moderate-to-high-potency statins. The intensity of statin therapy did not improve LDL-cholesterol goal attainment. Among patients on combination therapy, 41% on statin plus ezetimibe and 46% on statin plus niacin achieved an LDL-cholesterol of <70 mg/dL ( and <0.0001 versus statin alone). If patients were switched to a high-potency statin LDL-cholesterol goal attainment of <70 mg/dL would increase to 46% and would increase up to 72% with combination therapy. Conclusions. Most coronary artery disease patients in clinical practice do not attain an LDL-cholesterol of <70 mg/dL, even among patients on high potency statins. The combination of statin plus either ezetimibe or niacin is the most effective regimen to achieve an LDL-cholesterol of <70 mg/dL, however, these drug combinations are used infrequently in clinical practice.

Publisher

Hindawi Limited

Subject

Organic Chemistry,Hematology,Endocrinology, Diabetes and Metabolism,Internal Medicine

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