Table 1
Patient characteristics at the time of the first lipid-lowering therapy (LLT) prescription.
| LOW INTENSITY | MODERATE INTENSITY | HIGH INTENSITY | LOW INTENSITY + EZETIMIBE | MODERATE INTENSITY + EZETIMIBE | HIGH INTENSITY + EZETIMIBE | |||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Episodes (n) | 2,343 | 17,800 | 7,573 | 112 | 1,525 | 1,205 | ||||||
| Age (years, P50, P25–P75) | 66.3 | 57.3–73.7 | 63.4 | 54.9–71.6 | 64.9 | 57.3–72.1 | 68.8 | 59.8–74.5 | 66.4 | 58.7–73.1 | 65.3 | 58.2–72.0 |
| Age cohorts (years), n (%) | ||||||||||||
| 40–69 | 1,478 | (63.1%) | 12,560 | (70.6%) | 5,157 | (68.1%) | 63 | (56.2%) | 972 | (63.7%) | 823 | (68.3%) |
| 70–85 | 865 | (36.9%) | 5,240 | (29.4%) | 2,416 | (31.9%) | 49 | (43.8%) | 553 | (36.3%) | 382 | (31.7%) |
| Female, n (%) | 1,166 | (49.8%) | 7,897 | (44.4%) | 3,126 | (41.3%) | 55 | (49.1%) | 709 | (46.5%) | 451 | (37.4%) |
| CV risk level, n (%) | ||||||||||||
| Very-high risk | 2,095 | (89.4%) | 15,816 | (88.9%) | 7,229 | (95.5%) | 107 | (95.5%) | 1,432 | (93.9%) | 1,182 | (98.1%) |
| High risk | 248 | (10.6%) | 1,984 | (11.2%) | 344 | (4.5%) | <5 | (Masked) | 93 | (6.1%) | 23 | (1.9%) |
| LDL-C controla, n (%) | 135 | (5.8%) | 794 | (4.5%) | 299 | (4.0%) | <5 | (Masked) | 106 | (7.0%) | 56 | (4.7%) |
| Comorbidities | ||||||||||||
| Obesity | 630 | (26.9%) | 4,842 | (27.2%) | 2,220 | (29.3%) | 31 | (27.7%) | 491 | (32.2%) | 380 | (31.5%) |
| Hypertension | 1,846 | (78.8%) | 13,249 | (74.4%) | 5,876 | (77.6%) | 92 | (82.1%) | 1,246 | (81.7%) | 976 | (81.0%) |
| Alcohol or drug abuse | 293 | (12.5%) | 2,555 | (14.4%) | 1,547 | (20.4%) | 14 | (12.5%) | 258 | (16.9%) | 292 | (24.2%) |
| Type 1 diabetes mellitus | 120 | (5.1%) | 847 | (4.8%) | 529 | (7.0%) | ≤5 | (Masked) | 121 | (7.9%) | 97 | (8.0%) |
| Type 2 diabetes mellitus | 1,419 | (60.6%) | 10,702 | (60.1%) | 4,812 | (63.5%) | 59 | (52.7%) | 983 | (64.5%) | 786 | (65.2%) |
| Atrial fibrillation | 162 | (6.9%) | 1,125 | (6.3%) | 613 | (8.1%) | 9 | (8.0%) | 112 | (7.3%) | 110 | (9.1%) |
| Primary hypertriglyceridemia | 227 | (9.7%) | 2,006 | (11.3%) | 1,200 | (15.8%) | 22 | (19.6%) | 300 | (19.7%) | 239 | (19.8%) |
| Stroke | 226 | (9.6%) | 1,873 | (10.5%) | 1,247 | (16.5%) | 8 | (7.1%) | 167 | (11.0%) | 194 | (16.1%) |
| Myocardial infarction | 123 | (5.2%) | 1,447 | (8.1%) | 1,624 | (21.4%) | 11 | (9.8%) | 200 | (13.1%) | 416 | (34.5%) |
| Peripheral artery disease | 156 | (6.7%) | 1,053 | (5.9%) | 893 | (11.8%) | 10 | (8.9%) | 148 | (9.7%) | 187 | (15.5%) |
| Unstable angina | 73 | (3.1%) | 706 | (4.0%) | 791 | (10.4%) | 9 | (8.0%) | 121 | (7.9%) | 236 | (19.6%) |
| Heart failure | 162 | (6.9%) | 1,206 | (6.8%) | 890 | (11.8%) | 8 | (7.1%) | 154 | (10.1%) | 206 | (17.1%) |
| Mental health disorder | 841 | (35.9%) | 6,084 | (34.2%) | 3,520 | (46.5%) | 58 | (51.8%) | 695 | (45.6%) | 602 | (50.0%) |
| Estimated glomerular filtration rate <60 mL/min | 324 | (13.8%) | 1,875 | (10.5%) | 1,153 | (15.2%) | 19 | (17.0%) | 299 | (19.6%) | 223 | (18.5%) |
[i] Abbreviations: CV: cardiovascular; LDL-C: low-density lipoprotein cholesterol; P50: median; P25: 25th percentile; P75: 75th percentile.
aAdjusted control by ESC 2011, 2016, and 2019 guidelines.
Table 2
Baseline lipid-lowering therapy prescription patterns for the total cohort and the two age cohorts.
| TOTAL COHORT(n = 407,500) | AGE COHORTS, n(%) | |||||
|---|---|---|---|---|---|---|
| 40–69 YEARS (n = 230,171) | 70–85 YEARS (n = 177,329) | |||||
| Low-intensity statin, n (%) | 28,728 | (7.0%) | 13,504 | (5.9%) | 15,224 | (8.6%) |
| Moderate-intensity statin, n (%) | 325,804 | (80.0%) | 183,028 | (79.5%) | 142,776 | (80.5%) |
| High-intensity statin, n (%) | 42,785 | (10.5%) | 27,581 | (12.0%) | 15,204 | (8.6%) |
| Low-intensity statin + ezetimibe, n (%) | 420 | (0.1%) | 193 | (0.1%) | 227 | (0.1%) |
| Moderate-intensity statin + ezetimibe, n (%) | 5,728 | (1.4%) | 3,221 | (1.4%) | 2,507 | (1.4%) |
| High-intensity statin + ezetimibe, n (%) | 4,035 | (1.0%) | 2,644 | (1.1%) | 1,391 | (0.8%) |
Figure 1
Rate of low-density lipoprotein-cholesterol (LDL-C) control events per 100 patient-years by lipid-lowering therapy (LLT) during follow-up.
Figure 2
Adjusted hazard ratios of achieving low-density lipoprotein cholesterol (LDL-C) control target following lipid-lowering therapy (LLT) prescription episodes in older patients (70–85 years), using episodes from middle-aged patients (40–69 years) as the reference.