Lipid lowering therapy in patients with atherosclerotic cardiovascular diseases: What matters in the real world?
This multicenter registry cohort study in Taiwan shows that failure to achieve recommended low-density lipoprotein cholesterol (LDL-C) goal, rather than the intensity of statin therapy, was associated with increased risk of cardiovascular events. The study evaluated data from 4,099 patients with atherosclerotic cardiovascular disease (ASCVD) in the Taiwan Secondary Prevention for patients with AtheRosCLErotic disease (T-SPARCLE) registry; 183 were on high-intensity statin, 2,338 (57%) on moderate-intensity statin, 412 on low-intensity statin and 1166 (28%) did not receive a statin. Overall, 1,781 (43%) patients failed to achieve the target LDL-C level of < 100 mg/dl (2.6 mmol/L). Over a median follow-up of 2 years, major adverse cardiovascular events occurred in 109 patients. Irrespective of the intensity of statin use, failure to attain the LDL-C target level was associated with a higher risk of major cardiovascular events compare with those patients who attained target LDL-C levels (hazard ratio 1.66, 95% CI 1.04 - 2.63, p = 0.03 for those on statins; and 2.04 95% CI 1.06 -3.94, p = 0.03 for those not on statins). These findings underline the need for improvement in lipid management in the real-world, with a specific focus on attainment of lipid goals.
Lipid lowering therapy in patients with atherosclerotic cardiovascular diseases: Which matters in the real world? Statin intensity or low-density lipoprotein cholesterol level? Data from a multicenter registry cohort study in Taiwan.
Yeh Y-T, Yin W-H, Tseng W-K et al.