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Background: Real-world effectiveness of ezetimibe (EZE) among atherosclerotic cardiovascular disease (ASCVD) patients on statin therapy is limited.
Methods: A retrospective cohort of adult ASCVD patients who had LDL-c ≥70mg/dL initiating EZE on statin between Jan 2007 – Jun 2015 was identified using Optum Clinformatics claims database. LDL-c reduction and goal attainment, defined as achieving LDL-c <70mg/dL 3-month post EZE initiation were described. Multivariable regression models were used to identify factors associated with LDL-c reduction and goal achievement.
Results: Overall (N=1,451), mean age was 65 years, 56% were male, 48% were on high-intensity statin with a mean baseline LDL-c of 123mg/dL. Three-months post initiation, 23% of patients stopped EZE; mean LDL-c was 94mg/dL corresponding to a 22% reduction; 28% of patients achieved goal. In patients with higher baseline LDL-c, we observed larger LDL-c reductions but fewer percentages achieving goal. Only 31% and 10% of patients with baseline LDL-c ≥100mg/dL and ≥130mg/dL reached goal, respectively. The regression models indicated higher baseline LDL-c, no baseline high-intensity statin use and worse EZE adherence were associated with smaller LDL-c reduction and reduced odds of achieving goal.
Conclusions: While we observed expected LDL-c reduction by EZE in real world ASCVD patients, only a small proportion reached goal. For these high CV risk patients, better treatment options with more potent LDL-C reduction may be warranted.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Advances in Lipid Management
Abstract Category: 3. Acute and Stable Ischemic Heart Disease: Therapy
Presentation Number: 1203-304
- 2017 American College of Cardiology Foundation