Low-Density Lipoprotein Cholesterol Goal Attainment Rates by Initial Statin Monotherapy Among Patients With Dyslipidemia and High Cardiovascular Risk in Japan　― A Retrospective Database Analysis

• Published in: Circulation Journal Vol. 82; no. 6; pp. 1605 - 1613
• Main Authors: Umeda, Tatsuya, Hayashi, Ai, Harada, Akiko, Okuyama, Kotoba, Baxter, Carl A., Tokita, Shigeru, Teramoto, Tamio
• Format: Journal Article
• Language: English
• Published: Japan The Japanese Circulation Society 25.05.2018
• Subjects: Cardiovascular risk; Dyslipidemia; Low-density lipoprotein cholesterol; Statins; Low-density lipoprotein cholesterol; Statins; Cardiovascular risk; Dyslipidemia
• ISSN: 1346-9843; 1347-4820
• DOI: 10.1253/circj.CJ-17-0971

Background:To understand the recent management status in Japan, we determined the low-density lipoprotein cholesterol (LDL-C) goal attainment (GA) rate of patients initiating statin monotherapy for dyslipidemia.Methods and Results:Dyslipidemic patients undergoing either primary prevention with high cardiovascular risk or secondary prevention (defined by 2012 Japan Atherosclerosis Society Guidelines) were retrospectively analyzed from a hospital-based claims database. In both groups, the LDL-C levels and GA rates of patients treated with intensive or standard statin monotherapy for ≥4 weeks (January 2012–August 2016) were evaluated. Among 1,501,013 dyslipidemic patients, 11,695 and 9,642 were included in the primary and secondary prevention groups, respectively. A total of 94% of patients underwent statin monotherapy as the initial lipid-lowering therapy, of which most (≥80%) took intensive statins. The proportions of patients in the primary prevention group who achieved an LDL-C goal <120 mg/dL by intensive and standard statins were 81.1% and 61.2%, respectively, and the proportions of those who achieved a goal <100 mg/dL in the secondary prevention group were 73.3% and 48.1%, respectively. The GA rates were similar regardless of disease complications.Conclusions:Most patients (>70%) in both groups achieved LDL-C management goals using intensive statin monotherapy. Further treatment approaches are required for high-risk patients not achieving LDL-C goals by initial statin monotherapy. Continuous efforts are crucial for adherence and persistence of lipid-lowering therapies.