Journal article
Achievement of LDL-C <55 mg/dL among US Adults : Findings from the cvMOBIUS2 Registry
The American heart journal, Vol.279, pp.107-117
01/2025
DOI: 10.1016/j.ahj.2024.06.012
PMID: 38972336
Abstract
Reflecting clinical trial data showing improved outcomes with lower LDL-C levels, guidelines across the globe are increasingly recommending a goal of LDL-C <55 mg/dL in persons with atherosclerotic cardiovascular disease (ASCVD). What proportion of patients with ASCVD are already meeting those goals in the US remains understudied.
Using electronic health record data from 8 large US health systems, we evaluated lipid-lowering therapy (LLT), LDL-C levels, and factors associated with an LDL-C <55 mg/dL in persons with ASCVD treated between 1/1/2021-12/31/2021. Multivariable modeling was used to evaluate factors associated with achievement of an LDL-C <55 mg/dL.
Among 167,899 eligible patients, 22.6% (38,016) had an LDL-C <55 mg/dL. While 76.1% of individuals overall were on a statin, only 38.2% were on a high-intensity statin,;5.9% were on ezetimibe, and 1.7% were on a PCSK9i monoclonal antibody (mAb). Factors associated with lower likelihood of achieving an LDL-C <55 mg/dL included: younger age (odds ratio [OR] 0.91 per 10y), female sex (OR 0.69), Black race (OR 0.76), and non-coronary artery disease forms of ASCVD including peripheral artery disease (OR 0.72) and cerebrovascular disease (OR 0.85), while high-intensity statin use was associated with increased odds of LDL-C <55 mg/dL (OR 1.55). Combination therapy (statin+ezetimibe or statin+PCSK9i mAb) was rare (4.4% and 0.5%, respectively) and was associated with higher odds of an LDL-C <55 mg/dL (OR 1.39 and 3.13, respectively).
Less than a quarter of US patients with ASCVD in community practice are already achieving an LDL-C <55 mg/dL. Marked increases in utilization of both high intensity statins and combination therapy with non-statin therapy will be needed to achieve LDL-C levels <55 mg/dL at the population level in secondary prevention.
Details
- Title: Subtitle
- Achievement of LDL-C <55 mg/dL among US Adults : Findings from the cvMOBIUS2 Registry
- Creators
- Ann Marie Navar - The University of Texas Southwestern Medical CenterNishant P. Shah - Duke UniversityPeter Shrader - Duke UniversityLaine E. Thomas - Duke UniversityZahid Ahmad - The University of Texas Southwestern Medical CenterClint Allred - University of UtahAlanna M. Chamberlain - Mayo ClinicElizabeth A. Chrischilles - University of IowaNafeesa Dhalwani - AmgenMark B Effron - University of QueenslandSalim Hayek - University of Michigan–Ann ArborLaney K. Jones - Genomic HealthBethany Kalich - AmgenMichael D. Shapiro - Wake Forest UniversityCezary Wójcik - AmgenEric D. Peterson - The University of Texas Southwestern Medical Center
- Resource Type
- Journal article
- Publication Details
- The American heart journal, Vol.279, pp.107-117
- Publisher
- Elsevier Inc
- DOI
- 10.1016/j.ahj.2024.06.012
- PMID
- 38972336
- ISSN
- 0002-8703
- eISSN
- 1097-6744
- Language
- English
- Electronic publication date
- 07/05/2024
- Date published
- 01/2025
- Academic Unit
- Pharmacy; Epidemiology
- Record Identifier
- 9984656633202771
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