Risk factors affecting the failed low-density lipoprotein level achievement rate in working-age male population at high cardiovascular risk.
WHAT IS KNOWN AND OBJECTIVE: The aim of this study was to clarify the low-density lipoprotein (LDL)-C level achievement rate and detect factors affecting the failed LDL-C achievement rate in patients treated with statins and anti-platelet agents using a large insurance claim database and health check-up data.
METHODS: Access to a large health insurance claims database, and health check-up data were obtained from Japan Medical Data Center (JMDC) Co. Ltd., Tokyo. The database was searched to identify employed working-age male patients who had started treatment with statin and anti-platelet drugs for the secondary prevention of cardiovascular events. These patients were enrolled in the retrospective cohort study, which included screening at 3 months and observation for 3 years. LDL-C levels were obtained from the annual health check-up data. The achievement rate for LDL-C < 100 was assessed for three consecutive years. Adherence was assessed using the proportion of days covered (PDC) for the statin, which was calculated from prescription data over a 3-year period.
RESULTS AND DISCUSSION: Overall, 294 patients (male/female, 294/0; age, 47.8 +/- 6.0 years; body mass index, 24.8 +/- 4.2 kg/m(2) ; hypertension, 76.2%; and diabetes mellitus, 20.4%) were included. The LDL-C achievement rate for three consecutive years after starting treatment with statin and aspirin was 49.7%, 51.4% and 45.9%, respectively. Factors affecting failed LDL-C on adjusted odds were lower adherence to PDC [0.96 (0.94-0.99), P < 0.001, 1% increase] and higher baseline LDL-C [1.01 (1.00-1.02), P = 0.037, 1 mg/dL increase].
WHAT IS NEW AND CONCLUSION: Our results suggest that in the working-age male population need to improve statin adherence, especially those with higher baseline LDL-C levels.
|ジャーナル名||Journal of clinical pharmacy and therapeutics|
|投稿者||Momo, Kenji; Yasu, Takeo; Yasui, Hiroshi; Kuroda, Sei-Ichiro|
|組織名||Department of Pharmacy, The Institute of Medical Science Hospital, The University;of Tokyo, Tokyo, Japan.;Department of Hospital Pharmaceutics, School of Pharmacy, Showa University,;Tokyo, Japan.;Department of Medicinal Therapy Research, Meiji Pharmaceutical University, Tokyo,;Japan.;Department of Hematology/Oncology, The Institute of Medical Science Hospital, The;University of Tokyo, Tokyo, Japan.|