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Article

Evaluating the Efficacy of a Pre-Established Lipid-Lowering Algorithm in Managing Hypercholesterolemia in Patients at Very High Cardiovascular Risk

by
Jean Philippe Henry
*,
Laurence Gabriel
,
Maria-Luiza Luchian
,
Julien Higny
,
Martin Benoit
,
Olivier Xhaët
,
Dominique Blommaert
,
Alin-Mihail Telbis
,
Benoit Robaye
,
Antoine Guedes
and
Fabian Demeure
Department of Cardiology, Université Catholique de Louvain, CHU UCL Namur, 5530 Yvoir, Belgium
*
Author to whom correspondence should be addressed.
J. Pers. Med. 2024, 14(10), 1044; https://doi.org/10.3390/jpm14101044
Submission received: 13 September 2024 / Accepted: 6 October 2024 / Published: 9 October 2024
(This article belongs to the Section Clinical Medicine, Cell, and Organism Physiology)
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Abstract

Background: Recent data from European studies (EUROASPIRE V, DA VINCI, SANTORINI) indicate that achieving the LDL cholesterol (LDL-C) target in patients at very high cardiovascular risk is uncommon. Additionally, using a combination therapy involving statins and ezetimibe remains infrequent. Methods: A single-center assessment of a pre-defined lipid lowering treatment algorithm’s effectiveness at achieving the LDL-C target in patients at very high cardiovascular risk one month and one year after hospitalization. Results: 81 patients were included, all in secondary prevention. The average age of the patient was 66.9 years, and the main cardiovascular risk factors included hypertension, diabetes mellitus, and smoking history. Following the predefined lipid-lowering algorithm specific to our study, which involves initiating high-intensity statin therapy or a combination of statin and ezetimibe depending on initial LDL-C levels and patient history; 30 (37%) patients initiated high-intensity statin therapy (Atorvastatin (40 mg, 80 mg) or Rosuvastatin (20 mg, 40 mg)), while 51 (63%) started combination therapy with high-intensity statin and ezetimibe 10 mg. After one year, 57 (70.4%) remained adherent to their initial treatment, achieving a mean LDL-C of 49.5 ± 16.9 mg/dL, with 36 (63.2%) of them reaching the LDL-C target of <55 mg/dL. A total of 13 patients discontinued treatment, and 9 were lost to follow-up, withdrew from the study, or died. Conclusion: Initiating dual statin and ezetimibe therapy or high-intensity statin therapy early, based on the expected treatment efficacy, holds the potential to more rapidly and effectively achieve LDL-C targets in a larger proportion of very high-risk cardiovascular patients.
Keywords: hypercholesterolemia; lipid-lowering treatment; cardiovascular risk; combination therapy hypercholesterolemia; lipid-lowering treatment; cardiovascular risk; combination therapy

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MDPI and ACS Style

Henry, J.P.; Gabriel, L.; Luchian, M.-L.; Higny, J.; Benoit, M.; Xhaët, O.; Blommaert, D.; Telbis, A.-M.; Robaye, B.; Guedes, A.; et al. Evaluating the Efficacy of a Pre-Established Lipid-Lowering Algorithm in Managing Hypercholesterolemia in Patients at Very High Cardiovascular Risk. J. Pers. Med. 2024, 14, 1044. https://doi.org/10.3390/jpm14101044

AMA Style

Henry JP, Gabriel L, Luchian M-L, Higny J, Benoit M, Xhaët O, Blommaert D, Telbis A-M, Robaye B, Guedes A, et al. Evaluating the Efficacy of a Pre-Established Lipid-Lowering Algorithm in Managing Hypercholesterolemia in Patients at Very High Cardiovascular Risk. Journal of Personalized Medicine. 2024; 14(10):1044. https://doi.org/10.3390/jpm14101044

Chicago/Turabian Style

Henry, Jean Philippe, Laurence Gabriel, Maria-Luiza Luchian, Julien Higny, Martin Benoit, Olivier Xhaët, Dominique Blommaert, Alin-Mihail Telbis, Benoit Robaye, Antoine Guedes, and et al. 2024. "Evaluating the Efficacy of a Pre-Established Lipid-Lowering Algorithm in Managing Hypercholesterolemia in Patients at Very High Cardiovascular Risk" Journal of Personalized Medicine 14, no. 10: 1044. https://doi.org/10.3390/jpm14101044

APA Style

Henry, J. P., Gabriel, L., Luchian, M.-L., Higny, J., Benoit, M., Xhaët, O., Blommaert, D., Telbis, A.-M., Robaye, B., Guedes, A., & Demeure, F. (2024). Evaluating the Efficacy of a Pre-Established Lipid-Lowering Algorithm in Managing Hypercholesterolemia in Patients at Very High Cardiovascular Risk. Journal of Personalized Medicine, 14(10), 1044. https://doi.org/10.3390/jpm14101044

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