Lipid-lowering therapy: modern possibilities and real clinical practice

Abstract

Aim. To monitor the scope and effectiveness of lipid-lowering therapy (LLT) in the out- and inpatient settings among people hospitalized at the National Medical Research Center for Therapy and Preventive Medicine.Material and methods. Retrospective analysis of randomly selected case records for April-May 2012, 2015 and 2022 (n=658).Results. From 2012 to 2022, the proportion of outpatients taking statins increased as follows: from 28,8 to 60,4% (from 22,2 to 73,3% for high cardiovascular risk (CVR) and from 34,8 to 91,7% for very high CVR). Patients with very high CVR were significantly more likely to be prescribed high-intensity statin therapy (from 3,8 to 45,8%). Inpatients with high CVR were prescribed statins less often (74,3%) than patients with very high CVR (93,6%). In 2022, compared to 2015, the proportion of inpatients who received combined LLT increased as follows — 8,9 vs 0,5% (p< 0,001). Target low-density lipoprotein cholesterol <1,4 mmol/l in 2022 was achieved in 18,2 and 13,6% of outpatients with high and very high CVR, respectively.Conclusion. Despite increase in the frequency of prescribing and the intensity of statin therapy, by 2022 there remains a large proportion of patients with high and very high CVR who do not receive adequate LLT, which allows them to achieve the target low-density lipoprotein cholesterol. It is important to note that modern LLT provides great opportunities for the implementation of clinical guidelines in practice.

Keywords

• lipid-lowering therapy
• statins
• atorvastatin
• rosuvastatin
• outpatient care
• low-density lipoprotein cholesterol
• cardiovascular risk
• hyperlipidemia