Frequency of High-Risk Patients Not Receiving High-Potency Statin (from a Large Managed Care Database)
| Autor: | Howard S. Friedman, Kim Heithoff, JoAnne M. Foody, Prakash Navaratnam, Temitope Olufade, Fatima Rodriguez |
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| Rok vydání: | 2015 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Statin Databases Factual medicine.drug_class computer.software_genre Risk Factors medicine Humans Potency Retrospective Studies Lipoprotein cholesterol High risk patients Database Atherosclerotic cardiovascular disease business.industry Incidence Managed Care Programs Cholesterol LDL Middle Aged Prognosis United States Goal attainment Cardiovascular Diseases Managed care Female lipids (amino acids peptides and proteins) Hydroxymethylglutaryl-CoA Reductase Inhibitors Cardiology and Cardiovascular Medicine business computer Follow-Up Studies |
| Zdroj: | The American Journal of Cardiology. 115:190-195 |
| ISSN: | 0002-9149 |
| Popis: | We examined trends in low-density lipoprotein cholesterol (LDL-C) goal attainment in high-risk patients and use of high-potency statins (HPS) in a large, managed-care database from 2004 to 2012. The 2013 American Heart Association/American College of Cardiology prevention guidelines recommend that subjects with atherosclerotic cardiovascular disease (ASCVD) should be prescribed HPS therapy, irrespective of LDL-C levels. Previous guidelines recommend an LDL-C target70 mg/dl. Patients diagnosed with ASCVD based on International Classification of Diseases, Ninth Revision codes with ≥1 LDL-C test from January 2004 to December 2012 were identified in the Optum Insight database. Patients were identified as treated if they received lipid-lowering therapy (LLT) within 90 days of the LDL-C measurement and untreated if they did not receive LLT treatment. LLT treated patients were stratified into HPS users or non-HPS LLT users. There were 45,101 eligible patients in 2004 and 40,846 in 2012. The proportion of high-risk patients who were treated with LLT increased from 61.4% (2004) to 70.5% (2008) then remained relatively constant until 2012 (67.9%). Mean LDL-C values in treated patients decreased from 103.7 ± 32.1 (2004) to 90.8 ± 31.4 mg/dl (2012). The proportion of patients treated with HPS increased from 13% in 2004 to 26% in 2012. Although the proportion of treated high-risk patients who achieve LDL-C70 mg/dl levels has increased sharply from 2004, approximately 3 of 4 patients still did not meet this target. Only 1/4 of ASCVD patients are on HPS. In conclusion, our findings highlight the need for renewed efforts to support guideline-based LDL-C treatment for high-risk patients. |
| Databáze: | OpenAIRE |
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