LDL-C Goals Attainment in Patients at Very High Cardiovascular Risk: A Multicentric RWE Evaluation in Colombia

Speaker(s)

Cordoba B1, Leon Giraldo H1, Quintero V2, Sabogal J3, Ayala M4, Buitrago AF5, Herrera A6, Zarate L7, Cruz J8, Velasquez J9, Rodriguez Ordonez P10, Albaran C11, Rojas Rodriguez M11, Londono S10, Gomez Mesa J1
1Fundación Valle de Lili, Cali, Colombia, 2Clínica El Rosario, Medellín, Colombia, 3Angiografía de Occidente, Cali, Colombia, 4Clínica Las Américas, Medellín, Colombia, 5Fundación Santa Fé de Bogotá, Bogotá, Colombia, 6Hospital Universitario del Valle, Cali, Colombia, 7DIME Clínica Neurocardiovascular, Cali, Colombia, 8Fundación Cardioinfantil – Instituto de Cardiología, Bogota, Colombia, 9Hospital Pablo Tobón Uribe, Bogota, Colombia, 10Sanofi, Bogota, CUN, Colombia, 11Sanofi, Bogota, Colombia

Presentation Documents

OBJECTIVES: Cardiovascular disease is the leading cause of morbidity and mortality in Colombia, making the management of risk factors such as dyslipidemia crucial. This study describes preliminary results of LDL-C goal attainment in very-high cardiovascular risk (VHR) patients in 2011, 2016, and 2021, in accordance with the ESC/EAS guidelines for the management of dyslipidemia.

METHODS: Retrospective, descriptive, multicenter cohort study including patients from 9 hospitals in 7 Colombian regions with Coronary Artery Disease reported in coronary angiographies (CA). Lipid-lowering therapy (LLT) information and lipid profile results at the time of CA and during a 12-month follow-up period were included. LDL-C goal attainment was evaluated based on the guidelines’ thresholds for each year (2011: <70mg/dL, 2016: <70mg/dL, 2021: <55mg/dL), considering the available LLT.

RESULTS: 466 out of 780 patients were included. Mean age was 65 years, and 72.7% were men. The principal indications for CA were non-ST-segment elevation myocardial infarction (33.4%) and unstable angina (28.0%). The distribution of patients across 2011, 2016, and 2021 was 78 (17%), 86 (18%), and 302 (65%), respectively. LDL-C goal was achieved in 15.2% of patients in 2011, 51.2% in 2016, and 31.3% in 2021. Mean LDL-C among those who achieved goals was 51.96mg/dL in 2011, 51.87mg/dL in 2016 and 42.07mg/dL in 2021, reflecting average reductions of 25.8%, 25.9% and 23.5%, respectively.

The most prescribed medications were lovastatin (56.8%) in 2011, atorvastatin (90.0%) in 2016, and rosuvastatin (54.7%) in 2021. Prescription of PCSK9 inhibitors was low (2.6%) during 2021.

CONCLUSIONS: Preliminary results showed that achievement of LDL-C target was insufficient, and the rate of statin monotherapy prescription was high in patients at VHR. This suggests the importance of strict patient monitoring and timely medical education on therapeutic escalation considering options like PCSK9 inhibitors, to achieve optimal clinical outcomes. A broader analysis with at least 3,500 patients is anticipated.

Code

CO115

Topic

Clinical Outcomes

Topic Subcategory

Clinical Outcomes Assessment

Disease

Cardiovascular Disorders (including MI, Stroke, Circulatory), Diabetes/Endocrine/Metabolic Disorders (including obesity)