Mind the Gap: A Single-center Study on Low-density Lipoprotein Cholesterol Target Gaps in Atherosclerotic Cardiovascular Disease Prevention.
Cardiovascular diseases (CVDs) remain the leading cause of death globally. Statin therapy significantly reduces cardiovascular risk in both primary and secondary prevention; however, real-world implementation of guideline-directed therapy and achievement of target low-density lipoprotein cholesterol (LDL-C) levels remain suboptimal, especially in low- and middle-income settings.
This cross-sectional observational study was conducted at the Hospital and Research Centre, including 198 adults (≥25 years) eligible for statin therapy based on atherosclerotic CVD (ASCVD) risk assessment or established CVD. Patients were categorized into primary or secondary prevention groups. Lipid profiles were assessed to determine LDL-C target attainment (<70 mg/dL) after at least 3 months of statin therapy. Factors contributing to nonachievement of the target LDL-C were analyzed descriptively.
Of 198 patients, 67.7% were eligible for primary prevention, yet only 3.7% were initiated on statins. All secondary prevention patients received statins, but only 4.7% achieved the target LDL-C. The most frequent reasons for nonattainment included inadequate dose escalation (59.0%), low patient perception of therapy importance (52.5%), financial barriers (49.2%), and pill burden (39.3%). True statin intolerance was rare (3.3%). Demographic analysis revealed a mean age of 62.18 ± 12.84 years and a male predominance (80.3%).
This study highlights critical gaps in statin use and LDL-C target attainment in both primary and secondary prevention. Systematic incorporation of ASCVD risk calculators, regular follow-up lipid profiling, structured dose optimization, patient education, and enhanced medication affordability are essential to improving real-world cardiovascular risk reduction and achieving global prevention targets.
This cross-sectional observational study was conducted at the Hospital and Research Centre, including 198 adults (≥25 years) eligible for statin therapy based on atherosclerotic CVD (ASCVD) risk assessment or established CVD. Patients were categorized into primary or secondary prevention groups. Lipid profiles were assessed to determine LDL-C target attainment (<70 mg/dL) after at least 3 months of statin therapy. Factors contributing to nonachievement of the target LDL-C were analyzed descriptively.
Of 198 patients, 67.7% were eligible for primary prevention, yet only 3.7% were initiated on statins. All secondary prevention patients received statins, but only 4.7% achieved the target LDL-C. The most frequent reasons for nonattainment included inadequate dose escalation (59.0%), low patient perception of therapy importance (52.5%), financial barriers (49.2%), and pill burden (39.3%). True statin intolerance was rare (3.3%). Demographic analysis revealed a mean age of 62.18 ± 12.84 years and a male predominance (80.3%).
This study highlights critical gaps in statin use and LDL-C target attainment in both primary and secondary prevention. Systematic incorporation of ASCVD risk calculators, regular follow-up lipid profiling, structured dose optimization, patient education, and enhanced medication affordability are essential to improving real-world cardiovascular risk reduction and achieving global prevention targets.