Risk factors affecting the failed low-density lipoprotein level achievement rate in working-age male population at high cardiovascular risk.

Abstract

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. 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 3months and observation for 3years. 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. Overall, 294 patients (male/female, 294/0; age, 47.8±6.0years; body mass index, 24.8±4.2kg/m2 ; 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, 1mg/dL increase]. Our results suggest that in the working-age male population need to improve statin adherence, especially those with higher baseline LDL-C levels.