Low-density lipoprotein cholesterol levels and lipid-modifying therapy prescription patterns in the real world: An analysis of more than 33,000 high cardiovascular risk patients in Japan
Open accessAbstract
BACKGROUND AND AIMS: Low-density lipoprotein cholesterol (LDL-C) is a key modifiable risk factor in the development of cardiovascular (CV) disease. In 2012, the Japan Atherosclerosis Society (JAS) issued guidelines recommending statins as first-line pharmacotherapy for lowering LDL-C in patients at high risk for CV events. This study assessed achievement of recommended LDL-C goals and lipid-modifying therapy (LMT) use in a high CV risk population in Japan. METHODS: Patients from the Medical Data Vision (MDV) database, an electronic hospital-based claims database in Japan, who met the following inclusion criteria were included in this study: LDL-C measurement in 2013; ≥20 years of age; ≥2 years representation in the database; and a high CV risk condition (recent acute coronary syndrome (ACS), other coronary heart disease (CHD), ischemic stroke, peripheral arterial disease (PAD) or diabetes). LDL-C goal attainment was assessed based on LDL-C targets in the JAS guidelines. RESULTS: A total of 33,325 high CV risk patients met the inclusion criteria. Overall, 68% of the cohort achieved guideline recommended LDL-C targets, with only 42% receiving current treatment with statins. Attainment of LDL-C goals was 68% for ACS, 55% for CHD, and 80% each for ischemic stroke, PAD, and diabetes patients. Concomitant use of non-statin LMTs was low. CONCLUSIONS: In a high CV risk population in a routine care setting in Japan, guideline recommended LDL-C goal attainment and utilization of statins and other LMT was low. In addition, physicians appeared to be more likely to consider the initiation of statins in patients with higher baseline LDL-C levels.
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The risk of CAD incidence plateaued at LDL-C levels ≤ 119 mg/dL.
“The risk of CAD incidence plateaued at LDL-C levels ≤ 119 mg/dL, which demonstrates the importance of maintaining an LDL-C level of < 120 mg/dL624).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [624]
In managing dyslipidemia expressed by hypertriglyceridemia, the non-HDL-C level is more useful than the LDL-C level.
“However, in managing dyslipidemia expressed by hypertriglyceridemia, the non-HDL-C level is more useful than the LDL-C level. This has been reported in a number of studies177–179, 623, 624, 626, 627, 647).”
From Japan Atherosclerosis Society (JAS) guidelines for prevention of atherosclerotic cardiovascular diseases 2017 (2018) · cites this paper as [624]
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- Authors
- Teramoto, T., Uno, K., Miyoshi, I., Khan, I., Gorcyca, K., Sanchez, R. J., Yoshida, S., Mawatari, K., Masaki, T., Arai, H., & Yamashita, S.
- Affiliations
- Teikyo University (JP)
- Sanofi (Japan) (JP)
- Sanofi (United States) (US)
- Regeneron (United States) (US)
- Institute for Molecular Science (JP)
- Kyoto University (JP)
- Rinku General Medical Center (JP)
- Corresponding author
- Teramoto, Tamio
- Venue
- Atherosclerosis
- Publisher
- Elsevier BV
- Published
- 2016-08
- Volume
- 251
- Pages
- 248-254
- ISSN
- 0021-9150 (ISSN-L)
- OpenAlex
- W2463742437
- Cited by
- 71
- References
- 41
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 3 · 2023: 3 · 2022: 5 · 2021: 10 · 2020: 8 · 2019: 9 · 2018: 17 · 2017: 10 · 2016: 1
- FWCI
- 13.68
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- Locations
- Atherosclerosis (publishedVersion, cc-by-nc-nd)
- PubMed (publishedVersion)
- Institutional Repositories DataBase (IRDB) (submittedVersion, cc-by-nc-nd)
- Funders
- European Society of Cardiology
- Topics
- Health Sciences › Medicine › Surgery › Lipoproteins and Cardiovascular Health
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
- Keywords
- LDL cholesterol, LDL-C goal attainment, lipid therapy, statins, high cardiovascular risk patients, acute coronary syndrome, coronary artery disease, ischemic stroke, peripheral arterial disease, diabetes mellitus, Japan
- MeSH terms
- Aged, Aged, 80 and over, Hypolipidemic Agents, Cardiovascular Diseases, Coronary Disease, Cross-Sectional Studies, Female, Humans, Japan, Cholesterol, LDL, Male, Middle Aged, Retrospective Studies, Risk Factors, Hydroxymethylglutaryl-CoA Reductase Inhibitors
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