The recommended LDL-C treatment goals, according to the 2019 European Society of Cardiology (ESC)/ European Atherosclerosis Society (EAS) Guidelines are < 1.8 mmol/L and < 1.4 mmol/L for patients with high and very high CVD risks respectively. Clinical practice guidelines on Dyslipidaemia generally advocate lowering LDL-C to treatment goals based on each individual’s CVD risk. The association between lowering of Low-Density Lipoprotein-Cholesterol (LDL-C) and reduction of cardiovascular diseases (CVD) is well-established. These results should be taken into consideration and provide further insight to clinicians when making statin adjustment recommendations in order to achieve LDL-C targets in clinical practice, particularly for Asian populations. In this study based on real-world data of Asian patients in primary care, it was shown that although statin titration substantially affected LDL-C levels and LDL-C goal attainment rates, the magnitude was lower than results reported from clinical trials. The improvement in LDL-C goal attainment ranged from 26.5% to 47.1% when statin intensity was up-titrated. These were comparatively lower than results from clinical trials (30 to 63%). ResultsĪmong the cohort of 11,499 patients, with a total of 266,762 visits, there were 1962 pairs of LDL-C values associated with a statin titration. For the “Titrators” cohort, the mean percentage change in LDL-C and absolute change in LDL-C goal attainment rates were computed for each permutation of statin intensity titration. Patients were grouped into “No statin”, “Non-titrators” and “Titrators” cohorts based on prescribing patterns. The statins were classified into low-intensity (LI), moderate-intensity (MI) and high-intensity (HI) groups according to the 2018 American College of Cardiology and American Heart Association (ACC/AHA) Blood Cholesterol Guidelines. MethodsĪ retrospective cohort study over a 5-year period, from April 2014 to March 2019 was conducted on a cohort of multi-ethnic adult Asian patients with clinical diagnosis of Dyslipidaemia in a primary care clinic in Singapore. This study aims to use real-world data to determine the effect on LDL-C levels and LDL-C goal attainment rates, when selected statins are titrated in Asian patients. However, statin adherence in actual practice tends to be suboptimal, leading to diminished effectiveness. Clinical trials have demonstrated that either initiating or up-titrating a statin dose substantially reduce Low-Density Lipoprotein-Cholesterol (LDL-C) levels.

Moderate intensity statin