Treatment of severe hyperlipidemia and associated cardiovascular outcomes: Data from a large healthcare system.

IF 4.6 3区医学 Q2 PHARMACOLOGY & PHARMACY

Journal of clinical lipidology Pub Date : 2025-06-19 DOI:10.1016/j.jacl.2025.06.011

Cameron Hallihan, Jianhui Zhu, Floyd Thoma, Vijay Nambi, Anurag Mehta, Anandita Agarwala, Oscar Marroquin, Suresh Mulukutla, Anum Saeed

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引用次数: 0

Abstract

Background: High intensity statin therapy is currently recommended for primary prevention of atherosclerotic cardiovascular disease (ASCVD) in patients with severe hyperlipidemia (HLD), defined as low-density lipoprotein cholesterol (LDL-C) of ≥190 mg/dL.

Objective: We investigated rates and dosages of statin use and associated ASCVD outcomes for patients with severe HLD.

Methods: In a large healthcare system network, patients without ASCVD with an LDL-C ≥ 190 mg/dL were identified and stratified further based on American College of Cardiology /American Heart Association 10-year risk score. Statin use was stratified as: guideline directed statin intensity (GDSI) (high intensity statin) or

Results: Out of 282,298 primary prevention patients, a total of 5205 (1.8%) had LDL-C ≥ 190 mg/dL out of whom 3.7% were on GDSI at the index visit. Over a 5-year follow up, 42% of high-risk patients with severe HLD achieved new GDSI initiation. Compared to patients on GDSI, those on no statin therapy were at significantly higher risk of myocardial infarction (MI) (hazard ratio [HR] = 2.36, 95% CI [1.38-4.04]) and stroke/transient ischemic attack (HR = 2.70, 95% CI [1.43-5.09]). Patients on

Conclusion: High intensity statins are underutilized among patients with severe HLD, which is linked to greater risk of ASCVD events.

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严重高脂血症的治疗和相关的心血管结局：来自大型医疗保健系统的数据。

背景：高强度他汀类药物治疗目前被推荐用于严重高脂血症（HLD）患者动脉粥样硬化性心血管疾病（ASCVD）的一级预防，HLD定义为低密度脂蛋白胆固醇(LDL-C)≥190 mg/dL。目的：我们调查了严重HLD患者他汀类药物的使用率和剂量以及相关的ASCVD结果。方法：在一个大型医疗保健系统网络中，根据美国心脏病学会/美国心脏协会10年风险评分，对LDL-C≥190 mg/dL的无ASCVD患者进行识别和进一步分层。他汀类药物的使用分为：指南指导他汀类药物强度（GDSI）（高强度他汀类药物）或结果：在282,298例一级预防患者中，共有5205例（1.8%）LDL-C≥190 mg/dL，其中3.7%在指数访问时使用GDSI。在5年的随访中，42%的严重HLD高危患者实现了新的GDSI起始。与接受GDSI治疗的患者相比，未接受他汀类药物治疗的患者心肌梗死（MI）（风险比[HR] = 2.36, 95% CI[1.38-4.04]）和卒中/短暂性脑缺血发作（HR = 2.70, 95% CI[1.43-5.09]）的风险明显更高。结论：重度HLD患者未充分使用高强度他汀类药物，这与ASCVD事件的高风险相关。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of clinical lipidology 医学-药学

CiteScore

7.00

自引率

6.80%

发文量

209

审稿时长

49 days

期刊介绍： Because the scope of clinical lipidology is broad, the topics addressed by the Journal are equally diverse. Typical articles explore lipidology as it is practiced in the treatment setting, recent developments in pharmacological research, reports of treatment and trials, case studies, the impact of lifestyle modification, and similar academic material of interest to the practitioner. Sections of Journal of clinical lipidology will address pioneering studies and the clinicians who conduct them, case studies, ethical standards and conduct, professional guidance such as ATP and NCEP, editorial commentary, letters from readers, National Lipid Association (NLA) news and upcoming event information, as well as abstracts from the NLA annual scientific sessions and the scientific forums held by its chapters, when appropriate.