In clinical practice, there exist a gap between lipid guidelines and lipid management - use of combination therapy and improving patient adherence should be prioritized
Major reasons for insufficient therapy:
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.
Various clinical guidelines recommend LLTs for ASCVD prevention
Occurrence of ASCVD events§ was assessed between hospital discharge for each patient’s index AMI¶ and their first fill for a PCSK9i.
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
ACS, acute coronary syndrome; ASCVD, atherosclerotic cardiovascular disease; CV, cardiovascular; CVD, cardiovascular disease; DA VINCI; EU-Wide Cross-Sectional Observational Study of Lipid-Modifying Therapy Use in Secondary and Primary Care; DYS IS II, Dyslipidemia International Study II; EUROASPIRE, European Action on Secondary Prevention Through Intervention to Reduce Events; GOULD, Getting to an Improved Understanding of Low-Density Lipoprotein Cholesterol and Dyslipidemia Management; LDL-C, l ow-density lipoprotein cholesterol; LLT, l ipid-lowering therapy; PALM, Patient and Provider Assessment of Lipid Management; PCSK9, proprotein convertase subtilisin/kexin type 9.
Nishikido T , Ray KK. The power of lipid registries for cardiovascular disease prevention. Curr Opin Lipidol. 2021;32(6):342-348. doi: 10.1097/MOL.0000000000000783. PMID: 34561312.(Nishikido T, et al. Curr Opin Lipidol. 2021;32(6):342-348