title: Assessment of statin therapy, LDL-C levels, and cardiovascular events among high-risk patients in the United States.
abstract: BACKGROUND
  Statins have demonstrated significant benefit in reducing cardiovascular disease (CVD) risk.
  
  
  OBJECTIVE
  To evaluate statin treatment patterns by intensity, elevated low-density lipoprotein cholesterol (LDL-C) levels, and cardiovascular (CV) events in high-risk CVD patients.
  
  
  METHODS
  Patients included were aged ≥ 18 years, with a coronary heart disease (CHD; Jan 1, 2007-Dec 31, 2011, index date) or CHD risk equivalent (CHD RE) diagnosis (Jan 1, 2007-Dec 31, 2010, index date), in the Truven MarketScan claims database, continuously enrolled for 2 years pre- and up to 1 (CHD) or 2 (CHD RE) years post-index. Patients with CHD, CHD RE, rhabdomyolysis, or chronic kidney disease any time pre-index were excluded. Statin therapy was assessed at baseline, 30, 90, and 365 days post-index. LDL-C values were captured in patients with available data at 30-day intervals up to 1 year. CV events were evaluated up to 1 year post-index. Descriptive statistics were used to report results.
  
  
  RESULTS
  There were 175,103 CHD and 68,290 CHD RE patients; 3333 CHD RE patients had post-index CV events. At 1 year, 38.7% of CHD patients and 44.3% of CHD RE patients with post-index CV events were not prescribed statins. Most patients who were prescribed statins, received a moderate-intensity statin. The percentage of patients with LDL-C ≥ 100 mg/dL reduced over time, but at 1 year, 29.3% of CHD and 30.0% of CHD RE patients with post-index CV events had LDL-C ≥ 100 mg/dL. At 1 year post-index, 9.9% CHD and 7.3% CHD RE patients had at least 1 CV event.
  
  
  CONCLUSIONS
  There is room for better LDL-C management among high-risk CVD patients to reduce their overall CV risk.
authors.affiliation: Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA. Electronic address: sudhir.unni@pharm.utah.edu.
authors.forename: Sudhir K
authors.initials: SK
authors.lastname: Unni
authors.affiliation: Global Health Economics, Amgen Inc., Thousand Oaks, CA, USA.
authors.forename: Ruben G W
authors.initials: RG
authors.lastname: Quek
authors.affiliation: Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA.
authors.forename: Joseph
authors.initials: J
authors.lastname: Biskupiak
authors.affiliation: US Scientific Affairs, Amgen, Inc., Thousand Oaks, CA, USA.
authors.forename: Vinson C
authors.initials: VC
authors.lastname: Lee
authors.affiliation: Department of Pharmacotherapy, College of Pharmacy, University of Utah, Salt Lake City, UT, USA.
authors.forename: Xiangyang
authors.initials: X
authors.lastname: Ye
authors.affiliation: Global Health Economics, Amgen Inc., Thousand Oaks, CA, USA.
authors.forename: Shravanthi R
authors.initials: SR
authors.lastname: Gandra
mesh_terms: D002318:Cardiovascular Diseases / Q000188:drug therapy* / Q000453:epidemiology / Q000378:metabolism*; D008078:Cholesterol, LDL / Q000378:metabolism*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012306:Risk; D014481:United States
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors
keywords: CHD; Cardiovascular; Hyperlipidemia; LDL; Low-density lipoprotein; Statin