Real-world exploration of LDL-cholesterol management in patients with atherosclerotic cardiovascular disease
Authors' conclusion
Within 5 diverse large health systems in the CardioHealth Alliance, more than half of the patients with ASCVD had uncontrolled LDL-C with significant disparities based on sex and race at baseline.
Study context
- Population
- Patients with prior atherosclerotic cardiovascular disease (ASCVD) and an low-density lipoprotein cholesterol (LDL-C) measurement in 2021, 5 US health systems (CardioHealth Alliance)
- Participants
- 216,074 patients
- Exposure
- Uncontrolled LDL-C vs controlled LDL-C
- Uncontrolled LDL-Cn = 129,886
- Outcome
- Achievement of guideline-directed LDL-C target (< 70 mg/dL)
Methodological details5 US health systems, electronic medical record data
- 5 US health systems
- Electronic medical record data
Main finding
As reported in the abstract
Uncontrolled LDL-C (≥ 70 mg/dL)
Uncontrolled LDL-C
60.1%
129,886
- Factor associated with failure to achieve LDL-C control: female sex, RR (95% CI 1.12-1.14), P < .001
- 1.13
- Factor associated with failure to achieve LDL-C control: Black race, RR (95% CI 1.14-1.17), P < .001
- 1.15
Observational data: associations, not effects.
Further findings
Baseline characteristics, uncontrolled vs controlled LDL-C
Female
Black
CAD
HF
DM
AF
CKD
Lipid lowering therapy (LLT) initiation among uncontrolled LDL-C not on LLT at baseline (n = 53,957 [41.5%]) · within 6 months of the uncontrolled LDL-C value
- Initiated on any LLT
- 21%
Original publication
Real-world exploration of LDL-cholesterol management in patients with atherosclerotic cardiovascular disease. Am Heart J. Published 16 October 2024. doi:10.
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