Key result
Female sex is linked to ~42% lower rates of achieving guideline-recommended LDL-C targets.
Why the study?
This analysis aimed to evaluate the proportion of high-risk patients achieving guideline-recommended LDL-C goals and explore predictors of therapeutic failure, focusing on the role of gender.
Does female gender predict a lower probability of achieving guideline-recommended LDL-C targets in high-risk cardiovascular patients?
Cohort (n=174,200)
Yes
Does female gender predict a lower probability of achieving guideline-recommended LDL-C targets in high-risk cardiovascular patients?
Fewer than 12% of high-risk secondary prevention and diabetic patients achieve contemporary LDL-C guidelines, exposing a severe gender disparity where women are significantly less likely to be optimally treated.
Women with high-risk MACCE or T2DM less likely to reach LDL-C targets; hypothesis-generating for gender-specific strategies.
BACKGROUND AND AIMS: Lowering low-density lipoprotein cholesterol (LDL-C) is the cornerstone of cardiovascular disease prevention. Collection of epidemiological data is crucial for monitoring healthcare appropriateness. This analysis aimed to evaluate the proportion of high-risk patients who achieved guidelines recommended LDL-C goal, and explore the predictors of therapeutic failure, with a focus on the role of gender. METHODS AND RESULTS: Health administrative and laboratory data from seven Local Health Districts in Tuscany were collected for residents aged ≥45 years with a history of major adverse cardiac or cerebrovascular event (MACCE) and/or type 2 diabetes mellitus (T2DM) from January 1, 2019, to January 1, 2021. The study aimed to assess the number of patients with optimal levels of LDL-C (<55 mg/dl for patients with MACCE and <70 mg/dl for patients with T2DM without MACCE). A cohort of 174 200 individuals (55% males) was analyzed and it was found that 11.6% of them achieved the target LDL-C levels. Female gender was identified as an independent predictor of LDL-C target underattainment in patients with MACCE with or without T2DM, after adjusting for age, cardiovascular risk factors, comorbidities, and district area (adjusted-IRR 0.58 ± 0.01; p < 0.001). This result was consistent in subjects without lipid-lowering therapies (adjusted-IRR 0.56 ± 0.01; p < 0.001). CONCLUSION: In an unselected cohort of high-risk individuals, females have a significantly lower probability of reaching LDL-C recommended targets. These results emphasize the need for action to implement education for clinicians and patients and to establish clinical care pathways for high-risk patients, with a special focus on women.
No takes yet. Share an insight, caveat, or question.
Berteotti et al. (2023) conducted a cohort in High-risk cardiovascular disease (MACCE and/or T2DM) (n=174,200). Female gender vs. Male gender was evaluated on Achievement of guideline-recommended optimal levels of LDL-C (<55 mg/dl for patients with MACCE and <70 mg/dl for patients with T2DM without MACCE) (adjusted-IRR 0.58 ± 0.01, p=<0.001). Female gender was identified as a strong independent predictor of failing to achieve recommended LDL-C targets in high-risk patients with MACCE or T2DM (adjusted-IRR 0.58, p<0.001).
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: