title: Low-density lipoprotein cholesterol levels and lipid-modifying therapy prescription patterns in the real world: An analysis of more than 33,000 high cardiovascular risk patients in Japan.
abstract: Low-density lipoprotein cholesterol (LDL-C) is a key modifiable risk factor in the development of cardiovascular (CV) disease. In 2012, the Japan Atherosclerosis Society (JAS) issued guidelines recommending statins as first-line pharmacotherapy for lowering LDL-C in patients at high risk for CV events. This study assessed achievement of recommended LDL-C goals and lipid-modifying therapy (LMT) use in a high CV risk population in Japan.
  
  
  
  Patients from the Medical Data Vision (MDV) database, an electronic hospital-based claims database in Japan, who met the following inclusion criteria were included in this study: LDL-C measurement in 2013; ≥20 years of age; ≥2 years representation in the database; and a high CV risk condition (recent acute coronary syndrome (ACS), other coronary heart disease (CHD), ischemic stroke, peripheral arterial disease (PAD) or diabetes). LDL-C goal attainment was assessed based on LDL-C targets in the JAS guidelines.
  
  
  
  A total of 33,325 high CV risk patients met the inclusion criteria. Overall, 68% of the cohort achieved guideline recommended LDL-C targets, with only 42% receiving current treatment with statins. Attainment of LDL-C goals was 68% for ACS, 55% for CHD, and 80% each for ischemic stroke, PAD, and diabetes patients. Concomitant use of non-statin LMTs was low.
  
  
  
  In a high CV risk population in a routine care setting in Japan, guideline recommended LDL-C goal attainment and utilization of statins and other LMT was low. In addition, physicians appeared to be more likely to consider the initiation of statins in patients with higher baseline LDL-C levels.
authors.affiliation: Teikyo Academic Research Center, 2-11-1, Kaga, Itabashi-ku, Tokyo 173-8605, Japan. Electronic address: ttera@med.teikyo-u.ac.jp.
authors.forename: Tamio
authors.initials: T
authors.lastname: Teramoto
authors.affiliation: Sanofi, Tokyo, Japan.
authors.forename: Kiyoko
authors.initials: K
authors.lastname: Uno
authors.affiliation: Sanofi, Tokyo, Japan.
authors.forename: Izuru
authors.initials: I
authors.lastname: Miyoshi
authors.affiliation: Sanofi, Bridgewater, NJ, USA.
authors.forename: Irfan
authors.initials: I
authors.lastname: Khan
authors.affiliation: Sanofi, Bridgewater, NJ, USA.
authors.forename: Katherine
authors.initials: K
authors.lastname: Gorcyca
authors.affiliation: Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Sanchez
authors.affiliation: IMS Japan K.K., Tokyo, Japan.
authors.forename: Shigeto
authors.initials: S
authors.lastname: Yoshida
authors.affiliation: IMS Japan K.K., Tokyo, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Mawatari
authors.affiliation: IMS Japan K.K., Tokyo, Japan.
authors.forename: Tomoya
authors.initials: T
authors.lastname: Masaki
authors.affiliation: Department of Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan.
authors.forename: Hidenori
authors.initials: H
authors.lastname: Arai
authors.affiliation: Rinku General Medical Center, Osaka, Japan.
authors.forename: Shizuya
authors.initials: S
authors.lastname: Yamashita
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002318:Cardiovascular Diseases / Q000097:blood* / Q000175:diagnosis; D008078:Cholesterol, LDL / Q000097:blood*; D003327:Coronary Disease / Q000188:drug therapy; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D000960:Hypolipidemic Agents / Q000627:therapeutic use; D007564:Japan; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors
chemical_list: D008078:Cholesterol, LDL; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D000960:Hypolipidemic Agents
keywords: Cardiovascular risk; Goal attainment; Japan; Lipid management