Volume 8, Issue 3, May 2020, Page: 18-25
Concordance to Guideline-recommended Statin Therapy: Real-world Evidence from India
Surendra Shamkant Borgharkar, Sun Pharmaceutical Industries Ltd., Mumbai, India
Soma Soumitra Das, Covance Scientific Services & Solutions Pvt. Ltd., Pune, India
Received: Apr. 13, 2020;       Accepted: Apr. 30, 2020;       Published: May 28, 2020
DOI: 10.11648/j.ajhr.20200803.11      View  65      Downloads  41
Abstract
To evaluate concordance to the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline on treatment of blood cholesterol for primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD) in India. Concordance to 2013 ACC/AHA guideline was assessed by retrospectively analyzing statin therapy prescribing practice as per ASCVD risk score in four statin-benefit groups in 23,295 patients aged 40-79 years from health facilities across India between 2017 and 2018. Mean (±SD) age of patients was 58.9 (±9.2) years; 62% were men; 60% (n=14,070) had clinical ASCVD. Among patients without ASCVD (n=7,122), 3.9% (n=278) had low-density lipoprotein-cholesterol (LDL-C) ≥190 mg/dL, 94.0% (n=6,694) had diabetes mellitus and 2.1% (n=150) patients had 10-year ASCVD risk ≥7.5%. Among 18,795 patients (81%) eligible for high-intensity statins, only 34% were concordant whereas 63% were treated with moderate-intensity statins. Among 2,290 patients eligible for moderate-intensity statins, 76% were concordant and 18% received high-intensity statins. Among patients with ASCVD (<75 years), 43% received high-intensity statins, 55% received moderate-intensity statins, while 2% did not receive statins. Among patients with diabetes and ASCVD risk <7.5%, 86% received moderate-intensity statins, but those with risk >7.5%, 83% remained under-treated. Most patients (82%) with LDL-C >190 mg/dL were prescribed with moderate-intensity statins. Most patients were receiving statins at dose non-concordant to 2013 ACC/AHA guideline, reflecting gaps in real-world practice of prescribing statins for primary and secondary prevention of ASCVD. Addressing care gaps and promoting compliance to optimize statin therapy will help reduce cardiovascular disease, especially in high-risk population among South Asians.
Keywords
Cardiovascular Disease, Statin Therapy, Real-world Evidence, Low-density Lipoprotein-Cholesterol, Cholesterol Guidelines
To cite this article
Surendra Shamkant Borgharkar, Soma Soumitra Das, Concordance to Guideline-recommended Statin Therapy: Real-world Evidence from India, American Journal of Health Research. Vol. 8, No. 3, 2020, pp. 18-25. doi: 10.11648/j.ajhr.20200803.11
Copyright
Copyright © 2020 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
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