| Description |
Cardiovascular disease (CVD) is a leading cause of morbidity and mortality for adults in the United States and has caused a significant amount of spending in healthcare. The guidelines issued by the National Cholesterol Education Program Adult Panel III emphasized the importance of low-density lipoprotein (LDL) with LDL reduction. Based on patient CV risk, the guidelines identified LDL as the primary target for cholesterol- lowering therapy. The guidelines also recommended the use of statins for both primary and secondary prevention based on patient risk profile. With strong evidence of effectiveness of statins in secondary prevention, the focus was on primary prevention. Many randomized clinical trials (RCTs) conducted to evaluate the effects of statin therapy have shown that statins lower LDL-C by 19% to 47%. However, statin therapy in real-world studies has not shown the same level of LDL-C reduction as seen in RCTs. In published studies, LDL-C goal attainment is defined as whether a patient achieves LDL-C levels based on their CVD risk, after a specific follow-up time or the end of the study. However, no studies have considered LDL-C as a modifiable risk factor that changes over time. Examining the association between LDL-C goal attainment and CVD in a time-dependent manner may provide a more accurate estimation of the association between LDL-C levels as modified by statin therapy. The research question of this study is whether more consistent LDL-C goal attainment reduces the incidence of CV events in primary prevention patients. The objectives of this study are to 1) identify quarterly LDL-C goal attainment per ATP-III guidelines in primary prevention patients in the real-world setting, and 2) to evaluate the relationship between the time-dependent LDL-C goal attainment and CVD outcomes. Results from this study suggested risk reduction of CVD risk with more consistent LDL-C goal attainment, highlighting the importance of pharmacotherapy with the right intensity of medications, as well as medication adherence. The findings presented here add to the knowledge of the association between LDL-C goal attainment and CV event risk reduction. |
