Why the study?
Current guidelines recommend high-intensity LLT after hospitalization for ASCVD, but prescribing patterns and factors associated with lower treatment likelihood in Italian post-discharge patients needed evaluation.
Despite guideline recommendations, the utilization of lipid-lowering therapy, particularly high-intensity regimens, remains low in real-world patients following an ASCVD event, highlighting a substantial unmet need.
Prescribing gaps after ASCVD discharge merit clinician audit of discharge practices; leaves open optimal strategies to boost high-intensity LLT uptake.
Current international guidelines strongly recommend the use of high-intensity lipid-lowering therapy (LLT) after hospitalization for atherosclerotic cardiovascular disease (ASCVD) events. With this study, our aim was to evaluate LLT prescribing in a large Italian cohort of patients after discharge for an ASCVD event, exploring factors associated with a lower likelihood of receiving any LLT and high-intensity LLT. Individuals aged 18 years and older discharged for an ASCVD event in 2019-2020 were identified using hospital discharge abstracts from two local health units of the Campania region. LLT treatment patterns were analyzed in the 6 months after the index event. Logistic regression models were developed for estimating patient predictors of any LLT prescription and to compare high-intensity and low-to-moderate-intensity LLT. Results: A total of 8705 subjects were identified. In the 6 months post-discharge, 56.7% of patients were prescribed LLT and, of those, 48.7% were high-intensity LLT. Female sex, older age, and stroke/TIA or PAD conditions were associated with a higher likelihood of not receiving high-intensity LLT. Similar predictors were found for LLT prescriptions. LLT utilization and the specific use of high-intensity LLT remain low in patients with ASCVD, suggesting a substantial unmet need among these patients in the contemporary real-world setting.
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Citarella et al. (2022) studied this question.
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