Lipid-lowering therapies underused for primary CVD prevention
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In a cohort of more than 400,000 patients at high risk for CVD requiring primary prevention, less than half were taking appropriately dosed statins and less than 10% were taking nonstatin lipid-lowering therapies, researchers reported.
For an abstract presented at the National Lipid Association Scientific Sessions, Ahmed A. Kolkailah, MD, MSc, cardiovascular medicine fellow at the University of Texas Southwestern Medical Center, and colleagues analyzed 412,913 patients (median age, 63 years; 50.4% men) included in the Cerner Real-World Dataset of electronic health records from 90 health systems.
“Contemporary treatment patterns in community practice are not well described,” Kolkailah and colleagues wrote on a poster. “Hence, we sought to explore the use and dosing of statin therapy and use of several classes of nonstatin lipid-lowering therapies in adults recommended for statins in primary prevention.”
All patients received outpatient care in 2017 and/or 2018, had medication data available 1 year before and 1 year after the outpatient care visit and qualified for primary prevention based on the 2013 American College of Cardiology/American Heart Association cholesterol guidelines in at least one of the following ways: age 40 to 75 years with diabetes (71.8%); age 40 to 75 years with 10-year atherosclerotic CVD risk of at least 7.5% (26.7%); or LDL at least 190 mg/dL (1.5%).
Patients were stratified by whether they were on an appropriate-intensity statin, an underdosed statin or no statin, and were also characterized by whether they were taking any nonstatin lipid-lowering therapies or nonprescription omega-3 fatty acids/fish oil supplements.
Among the cohort, 46.5% were on an appropriate statin, 6.6% were on an underdosed statin and 46.9% were on no statin, Kolkailah and colleagues found.
In addition, 8.1% of patients were taking any nonstatin lipid-lowering therapies, according to the researchers.
Moreover, 9.3% were taking nonprescription omega-3 fatty acids/fish oil supplements “despite a lack of cardiovascular benefit,” Kolkailah and colleagues wrote on the poster.
“There remains a strong national need to improve overall utilization and evaluate barriers to prescription/uptake of evidence-based [lipid-lowering therapies] in all patients eligible for primary prevention,” they wrote.
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Kolkailah AA, et al. Abstract 73. Presented at: National Lipid Association Scientific Sessions; June 2-5, 2022; Scottsdale, Arizona (hybrid meeting).
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