Table 4.
Lipid-lowering treatments and LDL cholesterol targets in primary prevention: high cardiovascular risk patients
| High or very high cardiovascular risk | |||
|---|---|---|---|
| Study | Study size | Treatment | Control |
| [73] | N = 3710 (39% DM) |
Statins: 100% Ezetimibe: 17.4% |
High risk patients (CVD, DM or SCORE >5%; n = 2574), LDLc >100 mg/dl: 60.7% SCORE >5% without CVD nor DM (n = 407), LDLc >100 mg/dl: 83.2% |
| [72] | N = 1828 2 visits |
At baseline, 1013 (55.4%) received at least 1 drug: Statins: 830 (45.4%) Ezetimibe: 126 (6.9%) Statin + ezetimibe: 8 (0.4%) At follow up: Statins: 1232 (67.4%) Ezetimibe: 332 (18.2%) Statin + ezetimibe: 61 (3.3%) |
LDLc levels <100 mg/dl in DM or CVD and LDLc <115 in high risk patients: Baseline: All 30.5%; CVD 40.4%; DM 35.8% Follow up: All 44.7%; CVD 65.3%; DM 50.4% LDLc <70 mg/dl: CVD 17.9%; DM 16.5% |
| [79] |
RCT. 2 arms: Experimental-EG (n = 33) Supportive system to decision making Control-CG (n = 44) |
Use of High intensity statins: EG: 74.6%/CG: 25.4% Statins + ezetimibe or niacin/laropiprant: GI: 32.4%/GC: 2.3% |
After 12 weeks: LDLc <70: 55% GI; 12.5% GC LDLc <100: 75% GI; 45.8% GC |
| [80] | N = 37 |
Statins: 100% Ezetimibe: 10.8% |
LDLc <130 md/dl: 43% |
| [81] | N = 222. | LLT: 85% |
LDLc <100 mg/dl: 51.3% of high risk patients LDLc <70 mg/dl: 7.5% of high risk patients |
| [77] | N = 3716 (15.5% calibrated-SCORE >5) | Statins: 25.3% |
Patients with SCORE between 5 and 10: LDLc <100 mg/dl: 10.61% SCORE >10 LDLc <70 mg/dl: 1.79% |
| [1] | N = 27,903 (n = 9335 with dyslipidemia) High–very high risk: 11.3% males and 2.3% female | LLT REGICOR >10: 50% males, 59% females |
LDLc <100 mg/dl in DM or high–very high risk: <3% LDLc <100 mg/dl in DM or <130 mg/dl in moderate to very high risk or <160 mg/dl in low risk): 46% males, 52% females |
| [75] | N = 2704 | LLT: 1634 (60.4%) |
LDLc <100 mg/dl in DM or CVD; <130 mg/dl others: 930 (34.4%) LDLc <100 mg/dl: 34.7% DM; 34.2% CVD |
| [82] | N = 217 |
Ezetimibe (monotherapy): 42.4% Ezetimibe + statins: 43.3% |
LDLc <100 mg/dl or 70 mg/dl: 43.8% of high or very high risk patients |
| [3] |
N = 11,544 Rate of awareness: 53.6% (53.5% males; 53.7% women) |
LLT treatment: 44.1% of patients aware of elevated LDLc 23.7% of all patients with elevated LDLc |
LDLc <115 mg/dl (<100 DM and CVD): 40.2% of treated patients (9.5% of total sample with elevated LDLc) LDLc <115 mg/dl (<70 DM and CVD): 31.3% (7.3%) % of DM or CVD patients with LDLc < 100 mg/dl: 40.5% or 43.6%, respect. % of DM or CVD patients with LDLc <70 mg/dl: 7.0% or 5.2% respectively |
LLT lipid-lowering treatment, FH familiar hypercholesterolemia, DM diabetes mellitus, CVD cardiovascular disease, LDLc low-density lipoprotein cholesterol, EG experimental group, CG control group