Lipids & metabolic liver disease
Persistent gaps in the implementation of lipid-lowering therapy in patients with established atherosclerotic cardiovascular disease: A French nationwide study
Authors' conclusion
In real life, one-third of French ASCVD patients was not regularly treated with LLT, highlighting the urgent need to develop implementation strategies for lipid management.
Study context
- Population
- French adults with established atherosclerotic cardiovascular disease (ASCVD) (2012–2021) identified by ICD-10 and/or procedure codes; mean age 72.2 years, 36.9 % women2,056,354 alive 31 Dec 2021
- Participants
- 2,206,305 adults
- Outcome
- Prevalence and determinants of LLT use (≥1 dispensing in the last quarter of 2021)
- Follow-up
- Last quarter of 2021
Methodological detailswhole-population, national health data system
- Whole-population
- National health data system
Main finding
As reported in the abstract
LLT use among patients alive on 31 Dec 2021
- No lipid-lowering therapy (LLT)
- 32.5 %
- Statin
- 64.8 %
- High-intensity statin
- 27.0 %
- Statin + ezetimibe
- 13.0 %
- PCSK9 inhibitor
- 0.25 %
Observational data: associations, not effects.
Further findings
Factors associated with absence of LLT use (logistic regression)
| aOR (95 % CI) | ||
|---|---|---|
| Female sex | 1.42 (1.41–1.43) | |
| 0.512Adjusted odds ratio (log scale) |
| Outcome | aOR (95 % CI) | |
|---|---|---|
| Factors associated with absence of LLT use (logistic regression)Age < 50 yearsvs 65-74 years | 2.23 (2.20–2.27) | |
| Factors associated with absence of LLT use (logistic regression)Age ≥ 85 yearsvs 65-74 years | 2.10 (2.08–2.13) | |
| Factors associated with absence of LLT use (logistic regression)Strokevs Myocardial infarction | 2.21 (2.19–2.23) | |
| Factors associated with absence of LLT use (logistic regression)PADvs Myocardial infarction | 1.88 (1.86–1.91) | |
| 0.512Adjusted odds ratio (log scale) |
Prevalence of established ASCVD among French adults · 2021
%
- Established ASCVD among 45,082,270 adults
- 4.89
- Coronary artery disease
- 56.1
- Cerebrovascular disease
- 40.4
- Revascularized peripheral artery disease (PAD)
- 14.5
Original publication
Persistent gaps in the implementation of lipid-lowering therapy in patients with established atherosclerotic cardiovascular disease: A French nationwide study. Diabetes Metab. Published 16 March 2025. doi:10.
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