Statins underprescribed for those with ASCVD
A study of more than a quarter of a million heart patients in Canada has revealed statins are “significantly” underutilized to treat lipid abnormalities in individuals with and at risk for atherosclerotic cardiovascular disease (ASCVD).
The research, spearheaded by Guanmin Chen, PhD, MD, MPH, and published July 15 in the Canadian Journal of Cardiology, also found that over one-third of eligible individuals who do receive statin therapy are undertreated. A total of 281,655 ASCVD patients in Alberta, Canada, were involved in the study, which linked multiple health system databases to examine the clinical characteristics, treatment patterns and LDL-cholesterol levels within the population.
“Despite the known benefits of statins, a significant treatment gap persists in patients with ASCVD or at high risk of developing ASCVD,” Chen, a senior biostatician and adjunct research assistant professor at the University of Calgary, said in a release. “We need to conduct additional research to better understand contemporary management of these patients.”
Patients’ LDL-C was assessed at two points during the study period and evaluated according to 2016 Canadian Cardiovascular Society guideline recommendations for achieving less than 2.0 mmol/L or a 50% reduction in LDL-C. Statin therapies were categorized as either low-, moderate- or high-intensity.
Chen et al. found 78% of subjects identified with ASCVD during the study had an index LDL-C test, and 66% were prescribed lipid-lowering therapies. Most patients receiving lipid-lowering therapies were taking moderate- to- high-intensity statins, but that population was also far less likely to achieve guideline-recommended LDL-C levels within the study period, suggesting they’re undertreated. An additional 40% of patients didn’t adhere to their treatment regimens.
“Given the remarkable treatment gap identified in these patients at risk for ASCVD, the current study results may help to facilitate new strategies to reduce the number of untreated or undertreated patients,” Chen said. “Additional research is needed to assess the reasons for the observed treatment gaps and their effects on morbidity, mortality and other important outcomes such as health-related quality of life, functional status, as well as healthcare resource utilization and costs.”
He said certain strategies, like standardizing care, implementing risk classification tools, reviewing EMRs and completing follow-up lipid profiles at patient discharge, might help close the apparent treatment gap. Other therapies, like PCSK9 inhibitors, have also emerged as options for LDL-C management among high-risk ASCVD patients.
After graduating from Indiana University-Bloomington with a bachelor’s in journalism, Anicka joined TriMed’s Chicago team in 2017 covering cardiology. Close to her heart is long-form journalism, Pilot G-2 pens, dark chocolate and her dog Harper Lee.