Author + information
- Dean Karalisa,b,
- Usha Mallyaa,b,
- Joseph Elassala,b,
- Ameen F. Ghannama,b,
- Rishab Guptaa,b and
- Susan Boklagea,b
Background: In March 2016, the ACC released their Expert Consensus Decision Pathway which provided additional guidance on the use of non-statin treatment (tx) such as ezetimibe (EZE) for high-risk patients (pts) who require additional LDL-C lowering.
Objective: To understand the predictors of LDL-C goal attainment with EZE tx in pts with atherosclerotic cardiovascular disease (ASCVD) or heterozygous familial hypercholesterolemia (FH).
Methods: The study included adults with ASCVD or FH from an electronic medical record database newly prescribed EZE (index) in Sept 1, 2014 thru August 31, 2016, with 1 additional follow up visit with EZE to proxy drug fills. Baseline (BL) LDL-C was evaluated in the 24-months prior to index. Logistic regression was used to evaluate predictors of achieving a particular goal (70 or 100mg/dL) on subsets where the baseline LDL-C was above each of these goals.
Results: The study had 4439 EZE pts whereby 56% of patients were male, mean age was 68.2. 83% of pts had ASCVD, 42% had comorbid diabetes and 45% had a history of smoking. 51% had BL LDL-C > 100mg/dL and 36% achieved a goal <100mg/dL. 77% had BL LDL-C > 70mg/dL and 20% of pts achieved a goal of <70mg/dL. Odds ratios of achieving goal for each of the subsets are in the table.
Conclusions: Pts who require LDL-C lowering beyond statin tx were less likely to achieve LDL-C goals of <70 or 100mg/dL with EZE if their BL LDL-C values were 30 mg/dL above goal. Other non-statin tx should be considered for those requiring more than modest decreases in LDL-C.
Poster Hall, Hall C
Friday, March 17, 2017, 10:00 a.m.-10:45 a.m.
Session Title: Advances in Cholesterol Measurement and Management
Abstract Category: 32. Prevention: Clinical
Presentation Number: 1106-050
- 2017 American College of Cardiology Foundation