Abstract 17254: Attainment of Low-Density Lipoprotein Cholesterol Goals in Patients at High Cardiovascular Risk: Results From a Managed Care Population Study
Background: US guidelines support LDL-C goals based on patient’s cardiovascular (CV) risk profile; however, more information is needed regarding contemporary real-world patterns of LDL-C goal attainment within specific high CV risk conditions.
Methods: Patients from the OptumInsight IMPACT Database (a large US multi-payer claims database) with an LDL-C measurement during July 2011 to June 2012 and high CV risk conditions were identified. Most recent LDL-C measurement was defined as the index date and high CV risk conditions were identified hierarchically during the pre-index period as follows: recent acute coronary syndrome (ACS, within 6 months pre-index date), coronary events (myocardial infarction, hospitalization for unstable angina, coronary revascularization), stroke, and peripheral vascular disease (PVD).
Results: In total, 110,739 patients met the inclusion criterion. Median (inter-quartile range [IQR]) age was 59 (53 to 65) years, 53.7% were male, and median (IQR) LDL-C was 116 (92 to 143) mg/dL. As of index date, 2.7% had a recent ACS, while 42.1%, 9.2%, and 46.0% had evidence of coronary events, stroke, and PVD, respectively. The following table represents a summary distribution of patients by LDL-C levels as of index date for different high CV risk conditions.
Conclusions: In a large, contemporary cohort of high CV risk patients, few achieved LDL-C goals of <70 mg/dL (optional goal for very high CV risk) or <100 mg/dL. Although LDL-C goal achievement was relatively higher in patients with conditions signifying higher CV risk (e.g. in patients with recent ACS or coronary events compared with PVD only), with highest achievement in patients with recent ACS, the majority of these patients were still above LDL-C goals. These data suggest the need for ongoing efforts to address gaps in LDL-C goal attainment and improving CV outcomes in high-risk patients.
- © 2013 by American Heart Association, Inc.