Intensity of Lipid Lowering With Statin Therapy in Patients With Cerebrovascular Disease Versus Coronary Artery Disease: Insights from the PALM Registry.

Xian, Ying

Navar, Ann Marie

Li, Shuang

Li, Zhuokai

Robinson, Jennifer

Virani, Salim S

Louie, Michael J

Koren, Andrew

Goldberg, Anne

Roger, Veronique L

Wilson, Peter WF

Peterson, Eric D

Wang, Tracy Y

2020-10-20T17:14:58Z

2020-10-20T17:14:58Z

2019-10

2020-10-20T17:14:56Z

Background Current treatment guidelines strongly recommend statin therapy for secondary prevention. However, it remains unclear whether patients' perceptions of cardiovascular risk, beliefs on cholesterol, or the intensity of prescribed statin therapy differs for patients with coronary artery disease (CAD) versus cerebrovascular disease (CeVD) versus both CAD and CeVD (CAD&CeVD). Methods and Results The PALM (Patient and Provider Assessment of Lipid Management) registry collected data on statin use, intensity, and core laboratory low-density lipoprotein cholesterol levels for 3232 secondary prevention patients treated at 133 US clinics. Among individuals with CeVD only (n=403), CAD only (n=2202), and CeVD&CAD (n=627), no significant differences were observed in patient-perceived cardiovascular disease risk, beliefs on cholesterol lowering, or perceived effectiveness and safety of statin therapy. However, patients with CeVD only were less likely to receive any statin therapy (76.2% versus 86.2%; adjusted odds ratio 0.64, 95% CI 0.45-0.91), or guideline-recommended statin intensity (34.6% versus 50.4%; adjusted odds ratio 0.60, 95% CI 0.45-0.81) than those with CAD only. Individuals with CeVD only were also less likely to achieve low-density lipoprotein cholesterol <100 mg/dL (59.2% versus 69.7%; adjusted odds ratio 0.79, 95% CI 0.64-0.99) than individuals with CAD alone. There were no significant differences in the use of any statin therapy or guideline-recommended statin intensity between individuals with CAD&CeVD and those with CAD only. Conclusions Despite lack of significant differences in patient-perceived cardiovascular risk or statin beliefs, patients with CeVD were significantly less likely to receive higher intensity statin or achieve low-density lipoprotein cholesterol <100 mg/dL than those with CAD only.

2047-9980

2047-9980

https://hdl.handle.net/10161/21617

eng

Ovid Technologies (Wolters Kluwer Health)

Journal of the American Heart Association

10.1161/jaha.119.013229

coronary artery disease

quality of care

secondary prevention

statin

stroke

Intensity of Lipid Lowering With Statin Therapy in Patients With Cerebrovascular Disease Versus Coronary Artery Disease: Insights from the PALM Registry.

Journal article

Xian, Ying|0000-0002-1237-1162

Peterson, Eric D|0000-0002-5415-4721

e013229

19

School of Medicine

Duke Clinical Research Institute

Neurology, Neurocritical Care

Medicine, Clinical Pharmacology

Duke

Institutes and Centers

Neurology

Clinical Science Departments

Medicine

Faculty

Medicine, Cardiology

Published

8