Journal article
25 years of lipid-lowering therapy: secular trends in therapy of coronary patients
Wiener Klinische Wochenschrift, v 137(9), pp 297-306
01 May 2025
PMID: 38743139
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Summary
Background and aim
Guidelines on dyslipidemia and lipid-lowering therapy (LLT) over the years recommend lower low-density lipoprotein cholesterol (LDL-C) goals by more intense therapy. Nevertheless, LDL‑C has increased in the general population. Real-world trends of LLT medication as well as of LDL‑C levels in cardiovascular high-risk patients are unclear.
Methods
From 2158 patients who were referred for elective coronary angiography, lipid medication was analyzed at admission in three cardiovascular observational studies (OS) over the last 25 years: OS1: 1999–2000, OS2: 2005–2008 and OS3: 2022–2023. The three studies were performed at the same cardiology unit of a tertiary care hospital in Austria.
Results
The proportion of patients without LLT significantly decreased from OS1 through OS2 to OS3 (49.4%, 45.6%, and 18.5%, respectively, p
trend
< 0.001). Moreover, the percentage of patients under high-intensity statin treatment significantly increased from 0% to 5.1%, and 56.5% (p
trend
< 0.001). Significantly more patients became treated by more than one compound (OS1: 1.8%, OS2: 1.6%, OS3: 31.2%; p
trend
< 0.001). In the latest OS3, a trend to fixed-dose combination of statins with ezetimibe was observed. Mean LDL‑C levels decreased from 129 mg/dL over 127 mg/dL to 83 mg/dL, respectively (p
trend
< 0.001). Of the patients on high-intensity therapy 34% met the recent ESC/EAS goals (LDL-C < 55 mg/dL), but only 3% on non-intense therapy.
Conclusion
We conclude that during the observational period of a quarter of a century, treatment intensity increased and LDL‑C levels improved considerably. Guidelines apparently matter in this high-risk population and are considered by primary care physicians.
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Details
- Title
- 25 years of lipid-lowering therapy: secular trends in therapy of coronary patients
- Creators
- Magdalena Ratz - Private University in the Principality of LiechtensteinJohannes B. Vogel - Private University in the Principality of LiechtensteinHeike Kührer - Vorarlberg Institute for Vascular Investigation and TreatmentChristoph H. Säly - Landeskrankenhaus FeldkirchAxel Mündlein - Vorarlberg Institute for Vascular Investigation and TreatmentAlexander Vonbank - Vorarlberg Institute for Vascular Investigation and TreatmentArthur Mader - Vorarlberg Institute for Vascular Investigation and TreatmentPeter Fraunberger - Private University in the Principality of LiechtensteinAndreas Leiherer - Private University in the Principality of LiechtensteinHeinz Drexel - Landeskrankenhaus Feldkirch
- Publication Details
- Wiener Klinische Wochenschrift, v 137(9), pp 297-306
- Publisher
- Springer Vienna
- Number of pages
- 10
- Resource Type
- Journal article
- Language
- English
- Web of Science ID
- WOS:001222576600001
- Scopus ID
- 2-s2.0-85193023519
- Other Identifier
- 991022197413604721
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- Collaboration types
- International collaboration
- Web of Science research areas
- Cardiac & Cardiovascular Systems