OBJECTIVES

Low-density lipoprotein-cholesterol (LDL-C) has been recognized as the dominant form of atherogenic cholesterol which can lead to clinical atherosclerotic cardiovascular disease (ASCVD), including myocardial infarction, angina, arterial revascularization, ischemic stroke, transient ischemic attack, peripheral artery disease, etc. Lipid-lowering therapies (LLTs) are recommended to prevent new ASCVD episodes. According to AHA guideline 2018, patients with a history of multiple major ASCVD events or 1 major ASCVD event and multiple high-risk conditions are categorized as very-high-risk ASCVD patients, whose LDL-C threshold of needing further LLTs is 1.8mmol/L (70mg/dL). The study aims to identify the demographic and clinical profiles of very-high-risk ASCVD patients in China, and to shed light on their choices of LLTs.

METHODS

This analysis was performed utilizing a Chinese hospital-information-system-based electronic database, SuValue^®, that included 80 million patients in 161 hospitals in China. The following outcomes were analyzed: prevalence of clinical ASCVD and very-high-risk ASCVD patients, patients characteristics including LDL-C level, and treatment patterns among this group population. Statistical analyses were conducted via R 3.5.1.

RESULTS

A total of 1.2 million clinical ASCVD patients were identified in the database and 31% of them were defined with very high risk per definition above. The average age of very-high-risk patients was 73 and 48.5% of them were female. About 62% of very-high-risk ASCVD patients were treated with statins and 3% of them were prescribed with high-intensity statins. The average LDL-C level for very-high-risk patients were 2.59±0.003mmol/L. About 81% of the very-high-risk ASCVD patients have LDL-C >1.8mmol/L (70mg/dL)

CONCLUSIONS

The population of very-high-risk ASCVD patients is relatively large with significant unmet medical needs since the LDL-C control was suboptimal in China. The gap between current treatment results and the guideline recommendation goals can be best met through a multicomponent strategy including raising awareness, improving healthcare education to facilitate lifestyle therapies, and adopting novel treatments.