Prescriptive Appropriateness and Efficacy of Cholesterol-Lowering Drugs in a Secondary Prevention Setting—A Retrospective Analysis from Two Italian Cardiac Rehabilitation Centers
2024

Cholesterol-Lowering Drugs in Cardiac Rehabilitation

Sample size: 155 publication Evidence: moderate

Author Information

Author(s): Francesca Saladini, Stefania Baggio, Federica Marcato, Francesco Campisi, Roberto Verlato, Giampaolo Pasquetto, Emanuele Bertaglia, Gaetano Povolo, Paolo Buja, Nicola Ferri

Primary Institution: Cittadella Town Hospital and Camposampiero Town Hospital, Italy

Hypothesis

The study aims to investigate the prescriptive appropriateness of cholesterol-lowering drugs among patients who experienced an atherosclerotic cardiovascular disease (ASCVD).

Conclusion

The study confirms the importance of properly calculating cardiovascular risk profiles and highlights the under-prescription of lipid-lowering drugs.

Supporting Evidence

  • Only 36.0% of patients had LDL < 55 mg/dL after treatment.
  • 79.4% of group 1 patients were treated with high-intensity statins.
  • 44.1% of group 1 patients presented a high risk of CV events.
  • Only 5.1% of group 1 patients had a low/moderate risk according to risk calculators.
  • PCSK9 inhibitors were underused, prescribed mainly for patients with a second CV event.

Takeaway

This study looked at how well doctors are prescribing cholesterol-lowering medications to heart patients and found that many patients aren't getting the right treatment.

Methodology

A retrospective analysis of medical records from patients who underwent cardiac rehabilitation after ASCVD in 2020, following ESC guidelines.

Potential Biases

Potential biases include underestimation of cardiovascular risk and clinical inertia in prescribing appropriate medications.

Limitations

The study is retrospective, with limited data on patient adherence and a small sample size due to COVID-19 restrictions.

Participant Demographics

Mean age of participants was 66.1 years, with 88.4% being male; high prevalence of overweight, diabetes, smoking, hypertension, and dyslipidemia.

Statistical Information

P-Value

p<0.001

Statistical Significance

p<0.001

Digital Object Identifier (DOI)

10.3390/jcm13247505

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