Lipid-lowering Treatment In Patients Research Articles

Management of lipid-lowering treatment in patients with ischemic stroke in Catalonia and Balearic Islands, Spain. Malic study phase 3. Preliminary results

Management of lipid-lowering treatment in patients with ischemic stroke in Catalonia and Balearic Islands, Spain. Malic study phase 3. Preliminary results

Management of lipid-lowering treatment in patients with ischemic stroke in Catalonia and Balearic Islands, Spain. Malic study phase 2

Management of lipid-lowering treatment in patients with ischemic stroke in Catalonia and Balearic Islands, Spain. Malic study phase 2

Effects of high- versus low-intensity lipid-lowering treatment in patients undergoing serial coronary computed tomography angiography: results of the multi-center LOCATE study.

To evaluate the effects of lipid-lowering medications of different intensities on total, calcified, and non-calcified plaque volumes in patients undergoing serial cardiac computed tomography angiography (CCTA). Individuals with chronic coronary syndromes from 11 centers were included in a retrospective registry. Total, calcified, and non-calcified plaque volumes were quantified and the relative difference in plaque volumes between baseline and follow-up CCTA was calculated. The intensity of lipid-lowering treatment was designated as low, moderate, or high, based on current recommendations. Of 216 patients (mean age 63.1 ± 9.7years), undergoing serial CCTA (median timespan = 824.5 [IQR = 463.0-1323.0] days), 89 (41.2%) received no or low-intensity lipid-lowering medications, and 80 (37.0%) and 47 (21.8%) moderate- and high-intensity lipid-lowering agents, respectively. Progression of total and non-calcified plaque was attenuated in patients on moderate-/high- versus those on no/low-intensity treatment and arrested in patients treated with high-intensity statins or PCSK9 inhibitors (p < 0.001). Halted increase of non-calcified plaque was associated with LDL-cholesterol reduction (p < 0.001), whereas calcified plaque mass and Agatston score increased irrespective of the lipid-lowering treatment (p = NS). The intensity of lipid-lowering therapy robustly predicted attenuation of non-calcified plaque progression as a function of the time duration between the two CCTA scans, and this was independent of age and cardiovascular risk factors (HR = 3.83, 95% CI = 1.81-8.05, p < 0.001). The LOCATE multi-center observational study shows that progression of non-calcified plaques, which have been previously described as precursors of acute coronary syndromes, can be attenuated with moderate-intensity, and arrested with high-intensity lipid-lowering therapy. DRKS00031954.

The Evaluation of Lipid-Lowering Treatment in Patients with Acute Coronary Syndrome in a Hungarian Invasive Centre in 2015, 2017, and during the COVID-19 Pandemic-The Comparison of the Achieved LDL-Cholesterol Values Calculated with Friedewald and Martin-Hopkins Methods.

Background/Objectives: Patients with acute coronary syndrome (ACS) represent a vulnerable population. We aimed to investigate serum lipid levels of patients with ACS upon admission and during one year of the COVID-19 pandemic in a rural county hospital, and compared these findings with the data of patients with ACS in 2015 and 2017. The secondary aim of this paper was the comparison of the LDL-C values calculated with the Friedewald and Martin-Hopkins methods. Methods: A retrospective analysis of lipid-lowering data of patients treated with ACS in 2015, 2017 and in a COVID-19 year (1 April 2020-31 March 2021) was performed; the patient's numbers were 454, 513 and 531, respectively. Results: In the COVID-19 period one year after the index event, only 42% of the patients had lipid values available, while these ratios were 54% and 73% in 2017 and in 2015, respectively. Using the Friedewald formula, in the COVID-19 era the median of LDL cholesterol (LDL-F) was 1.64 (1.09-2.30) mmol/L at six months and 1.60 (1.19-2.27) mmol/L at one year, respectively. These values were 1.92 (1.33-2.27) mmol/L and 1.73 (1.36-2.43) mmol/L using the Martin-Hopkins method (LDL-MH). The LDL-F yielded significantly lower values (15% lower at six months, p = 0.044; and 8% lower at one year, p = 0.014). The LDL-F reached the previous target of 1.8 mmol/L during the COVID-19 pandemic 36% at one year vs. 48% in 2017, and 37% in 2015. The recent target LDL-C level of 1.4 mmol/L was achieved in 22% of cases in the COVID-19 pandemic, 16% in 2015 and 19% in 2017. Conclusions: A significantly lower proportion of patients with ACS had available lipid tests during the COVID-19 pandemic. Besides the lower number of available samples, the proportion of achieved 1.4 mmol/L LDL-C target lipids was stable. More rigorous outpatient care in the follow-up period may help to improve the quality of lipid lowering treatments and subsequent secondary cardiovascular prevention. If direct LDL-C determination is not available, we prefer the LDL calculation with the Martin-Hopkins method.

Lipoprotein (a) and lipid-lowering treatment from the perspective of a cardiac surgeon. An impact on the prognosis in patients with aortic valve replacement and after heart transplantation

Lipoprotein(a) is a recognized risk factor for ASCVD. There is still no targeted therapy for Lp(a), however, drugs such as pelacarsen, olpasiran, zerlasiran, lepodisiran and muvalaplin are in clinical trials and have been shown to be effective in significantly reducing Lp(a) levels. Moreover, elevated Lp(a) levels significantly affect the prognosis of patients after aortic valve replacement (AVR) and heart transplantation (HTx). Therefore, the assessment of Lp(a) concentration in these patients will allow for a more accurate stratification of their cardiovascular risk, and the possibility of lowering Lp(a) will allow for the optimization of this risk. In this article, we summarized the most important information regarding the role of Lp(a) and lipid-lowering treatment in patients after AVR and HTx.

Strategy of lipid-lowering treatment in patients with acute coronary syndrome. The ELECTRA-SIRIO 2 investigators’ viewpoint

Strategy of lipid-lowering treatment in patients with acute coronary syndrome. The ELECTRA-SIRIO 2 investigators’ viewpoint

Lipid lowering treatment after percutaneous coronary intervention: data from the large contemporary ZON-HR registry

Abstract Background Low density lipoprotein-C (LDL-C) reduction in patients who underwent percutaneous coronary intervention (PCI) is recommended by ESC guidelines to prevent ischemic events. This is mainly achieved by secondary prevention with lipid lowering treatment. The ‘’Zuid-Oost Nederland Heart Registry’’ (ZON-HR) is a multicentre prospective registry designed to improve secondary prevention after PCI by a patient-tailored approach. Purpose To describe the use of lipid lowering treatment in patients who underwent PCI in the ZON-HR. Methods Since November 2020 data from all 4628 patients who underwent PCI were included in four hospitals. Patient characteristics, LDL-C values at baseline and medication at discharge were collected. The association between predefined variables and lipid lowering treatment was assessed with multivariable logistic regression. Results LDL-C at baseline was available in 2325 patients. The mean age was 67.8 year and 73.5% was male (table 1). ACS patients had a significantly higher baseline LDL-C value compared with CCS patients (2.81 mmol/l vs 2.45 mmol/l). However, even in CCS patients LDL-C values were &amp;gt;2 mmol/L. There was a different pattern in lipid lowering treatment at discharge after ACS or CCS. Statins were prescribed significantly more frequent in ACS patients, while ezetimibe was prescribed significantly more frequent in CCS patients compared to ACS patients. Mono and combination therapy was prescribed more often in ACS patients compared to CCS patients. Increasing age and CCS indication for PCI were predictors for not receiving any lipid lowering medication at discharge. Also, patients with a higher LDL-C baseline value had a smaller chance to receive lipid lowering medication at discharge. Conclusion LDL-C reduction is the cornerstone of secondary prevention after PCI for CCS and ACS. 8.9% of ACS and 18.2% of CCS patients receive no lipid lowering treatment. Also, patients with scheduled PCI (CCS) had LDL-C values above target. Age and CCS are independent predictors for not receiving lipid lowering treatment. ZON-HR will develop and integrate initiatives to improve lipid lowering secondary prevention.Baseline characteristicsPredictors lipid lowering medication

The real-world data of lipid-lowering treatment in patients with peripheral artery disease and its association with severity of disease

BackgroundThe risk of coronary artery disease in peripheral arterial disease (PAD) is high, life prognosis is poor, and lipid-lowering treatment with statins has been reported to improve prognosis. In clinical practice, however, hypolipidemia is more common in patients with severe PAD and statin prescription rates appear to be low, but specific data are scarce in Japan. Therefore, we conducted this cross-sectional study in collaboration with other centers of vascular surgery to determine the rate of statin prescriptions for PAD patients in real-world practice, the rate of achievement of low-density lipoprotein (LDL) cholesterol control targets, and whether statin non-use is a determinant factor of critical limb ischemia (CLI). MethodsA total of 246 PAD patients (97 with CLI) from 5 sites were included in this study. Medical history and blood test data were obtained from medical records and interviews with patients, and were compared between CLI and non-CLI patients. ResultsStatin prescription rate was only 34 %. The overall LDL cholesterol control target rate was 46 % of CLI cases and 51 % of non-CLI cases, according to the lipid management criteria of the Japanese Society for Atherosclerosis 2022 guidelines. Patients in the CLI group had a lower mean body mass index and lower LDL cholesterol levels than those in the non-CLI group, suggesting that these factors were responsible for the lower statin prescription rate. However, multivariate analysis revealed that statin non-use was one of the determinants of CLI. ConclusionsStatin prescription rates for PAD patients were low in real-world practice settings in the field of vascular surgery. Since statin non-use is a determinant of CLI, there is a need to educate physicians engaged in treatment regarding lipid-lowering treatment with statins.

Effect of lipid-lowering treatment on lipid and glycemic profile of patients with elevated lipoprotein(a) levels

Aim: The evaluation of the effect of lipid-lowering treatment in patients with elevated levels of lipoprotein(a) [Lp(a)]. Material and methods: A prospective study including 70 patients with dyslipidemia and elevated Lp(a) levels (&gt;30 mg/dL) attending a Lipid Clinic in Greece. Subjects were allocated to the following therapies according to the national guidelines for cholesterol management: high-intensity statin monotherapy (S; n=28), ezetimibe added to high-intensity statin (SE; n=31), and proprotein convertase subtilisin/kexin type 9 (PCSK9) inhibitor added to high-intensity statin plus ezetimibe (SEP; n=11). Follow-up duration was 3 months. We investigated the effect of these lipid-lowering interventions on participants’ lipidemic and glycemic profile. Comparisons between groups were adjusted for the baseline levels of the studied parameters. Results: Mean age was 51 ± 15 years, 40% were male, 39% were diagnosed with familial hypercholesterolaemia (FH), 16% with atherosclerotic cardiovascular disease (ASCVD), while 36%, 33% and 15% were at very high, high, and moderate cardiovascular risk, respectively. All interventions significantly reduced apolipoprotein B (apoB), total cholesterol (TC) and low-density lipoprotein cholesterol (LDL-C), but only PCSK9 inhibitors significantly reduced Lp(a) levels (SEP: -28% vs SE: +11% vs S: +17%, p&lt;0.05). Patients in the SE group achieved the highest rates of LDL-C target attainment (SEP: 36.4% vs SE: 12.9% vs S: 3.6% for LDL-C &lt;55 mg/dL; SEP: 36.4% vs SE: 16.1% vs S: 7.1% for LDL-C &lt;70 mg/dL, p&lt;0.05 for the comparison among groups). No significant effect on glycemic profile across treatment groups was noted. Conclusions: Add-on PCSK9 inhibitors were associated with the highest rates of LDL-C target achievement compared with high-intensity statin ± ezetimibe in high-risk patients with elevated Lp(a) and were the only class to significantly lower Lp(a) levels.

Lipid-lowering treatment of patients with statin intolerance – Interim analysis of an observational, prospective, multicenter registry

Lipid-lowering treatment of patients with statin intolerance – Interim analysis of an observational, prospective, multicenter registry

Clinical consequences of the lipid-lowering treatment in patients with acute coronary syndrome: real-world retrospective study (LipidACS study)

Abstract Background The reduction of low-density lipoprotein cholesterol (LDLc) levels is Key for improving the prognosis of patiens with acute coronary syndrome (ACS). Purpose To estimate the clinical characteristics and treatments of patients with a first episode of ACS in real world in a large database in Spain. Methods An observational and retrospective study was carried out based on electronic medical records of primary care centers and hospitals including 969.587 spanish patients aged &amp;gt;18 years.From these, we selected the ones with a first episode of ACS between 01/07/2016 and 30/06/2018, with a follow-up period of 18 months. Patients were divided according to the intensity of their lipid-lowering treatments: low, moderate, high (high intensity statin/moderate plus ezetimibe), very high (high intensity statin plus ezetimibe) and extreme (IPCSK added) and those on treatment with lipid-lowering drugs other than statins. The incidence of new cardiovascular events, the reduction of LDLc levels, the persistence rates at 9 and 18 months, and the mortality rates were estimated. The concomitant treatments prescribed at the start of the study were registered. Results A first episode of ACS was detected in 7,150 patients (mean age: 70 years [SD: 9.6]; males: 62.2%). The intensity of their lipid-lowering treatments: low [n=172 (2.4%)], moderate [n=370 (5.2%)], high [n=3,751 (52.5%)], very high [n=2,457 (34.4%)], extreme [n=67 (0.9%)])and non-statins lipid-lowering treatments (n=333 [4.7%]). Patients with lipid-lowering treatments other than statins had the highest incidence rate of cardiovascular events (33.0%), followed by those on treatment with low intensity treatments (32.0%): acute myocardial infarction and angina were the most frequent cardiovascular events. The deepest reductions of LDLc levels at 18 months were reported in patients with extreme intensity and very-high intensity treatments (−60.5 mg/dL [42.9%] and −31.6 mg/dL [24.3%], respectively). The persistence rates at 9 and 18 months were higher in patients with extreme intensity and very high intensity lipid-lowering treatments. The highest mortality rate was observed in patients with lipid-lowering treatments other than statins (12.6%), with the median time to death being 221 days (P25–P75: 116–327). The lowest mortality rate was registered in patients with extreme intensity lipid-lowering treatments, who showed a median time to death of 405 days (P25–P75: 396–0).Overall, referral to Cardiac Rehabilitation in ACS is less than 20% in Spain. Conclusion Patients with ACS who received lipid-lowering treatments other than statins and low intensity treatments had the highest incidence of cardiovascular events and mortality rates.The reduction of LDLc levels increased with the intensity of the lipid-lowering treatments, which may lead to a reduced risk of cardiovascular events and death. More referral to Cardiac Rehabilitation could also improve these results Funding Acknowledgement Type of funding sources: Private company. Main funding source(s): SANOFI

Study of common hypertriglyceridaemia genetic variants and subclinical atherosclerosis in a group of women with SLE and a control group

ObjectiveSLE is associated with increased cardiovascular risk (CVR). High serum concentrations of triglyceride-rich lipoproteins and apolipoprotein B-rich particles constitute the characteristic dyslipidaemia of SLE.MethodsA cross-sectional study was conducted to study...

Management of lipid-lowering treatment in patients with ischemic stroke in Catalonia and Balearic Islands, Spain. Malic study phase 2. Preliminary results

Management of lipid-lowering treatment in patients with ischemic stroke in Catalonia and Balearic Islands, Spain. Malic study phase 2. Preliminary results

Abstract P039: Low-density Lipoprotein Management In Patients With Peripheral Artery Disease With And Without Severe Hypercholesterolemia In A Largely Rural Population

Background: Elevated low-density lipoprotein cholesterol (LDL) is associated with increased risk for peripheral artery disease (PAD) and major limb or adverse cardiovascular events. We aimed to compare the prevalence and appropriate lipid-lowering treatment of patients diagnosed with PAD with and without prior phenotypic severe hypercholesterolemia (SH) in a large, rural healthcare system. Methods: Retrospective study of ambulatory adults with a lipid panel at Essentia Health clinics obtained between 7/1/2016-6/30/2019 (MN, WI, and ND, USA) with PAD on the problem list (defined based on ICD-9/10 codes). Patients were divided into two groups, PAD only and PAD with SH. Phenotypic SH was defined as any prior LDL ≥ 190 mg/dL. Patients were excluded if they were currently pregnant (n=232) or if they did not have repeat LDL &gt; 30 days apart (n=1684). High-intensity statin was considered atorvastatin 40mg or 80mg or rosuvastatin 20mg or 40mg daily. Results: A total of 10,874 patients were previously diagnosed with PAD (mean age 40.4 + 10.9, 43.3% female (N=4711), 58.1% rural (N=6319). A total of 13.6% (N=1484) had SH. Patients with PAD and SH were more likely to be female, urban, have prior acute limb ischemia, stroke/transient ischemic attack, and were less likely to have diabetes or chronic limb ischemia than patients with PAD only. Patients with PAD and SH were more likely to be on a high intensity statin than those with PAD only (65.8% (N=977) vs. 51.3% (N=4813); p&lt;0.001). Very few patients received no lipid-lowering therapy (PAD with SH 0.7% (N=10) vs. PAD alone 2.1% (N=234). More patients with PAD and SH received PCKS9 inhibitors (2.5% (N=37) vs 0.4% (N=39); p&lt;0.001) and ezetimibe (23.4% (N=347) vs. 8.1% (N=760); p&lt;0.001) than patients with PAD only. Approximately 50% (N=749) of PAD with SH patients achieved a 50% lowering from peak LDL compared to 28.9% (N=2717) with PAD only. Mean LDL in the PAD with SH was 113.9 + 43.4 mg/dL compared to 81.8 + 29.1 mg/dL in patients with PAD without SH. However, fewer patients with PAD and SH achieved a LDL &lt;70 mg/dL compared to those with PAD only (13.3% (N=197) vs 37.1% (N=3487), p&lt; 0.001). Conclusion: One in 10 patients with PAD has a history of SH and majority are not achieving target LDL&lt;70mg/dL. There is an urgent need for more aggressive lipid-lowering therapy for all patients with PAD.

Management of lipid-lowering treatment in patients with ischemic stroke in Catalonia, Spain.

Background and Aims: LDL-C is the causative agent of atherosclerosis, its levels are directly related to increased cardiovascular mortality. Lipid-lowering treatment is effective in reducing risk of new events, although the achievement of the therapeutic objectives is far from the current recommendations. In Catalonia, we do not have any registry on the management of lipids in stroke patients. To know the strategy used for the prescription of lipid-lowering treatment in patients with atherothrombotic acute ischemic stroke in hospital care in Catalonia, Spain.

Javaslat az európai és hazai ajánlásokat követő lipidcsökkentő terápia hatékonyabb megvalósítására a magyarországi gyakorlatban akut koronáriaesemény utáni betegekben

The most recent studies and meta-analyses proved that the lipid lowering therapy, the lowering of LDL-cholesterol level has become the key element of the primary and secondary cardiovascular prevention. There is no difference which drug is used, but LDL-cholesterol must be decreased to the lowest achievable level, as soon, as long and as low, as possible. Obviously, it is clear as well, that if the risk is higher, the available benefit is greater. At the same time we have to recognise that in lipid lowering treatment of patients after acute coronary syndrome there is still remaining room and urgent task for improvement. The presidents and general secretaries of two medical associations, the Hungarian Society of Cardiology and the Hungarian Atherosclerosis Society, and the leaders of cardiology departments of four counties in the North-Eastern part of Hungary (Borsod-Abaúj-Zemplén, Szabolcs-Szatmár-Bereg, Hajdú-Bihar and Békés) and a cardiologist working as a general practitioner too, developed a common action plan to improve the lipid lowering treatment in patients after ACS. Its key elements are: 1.) detailed instructions for patients about next steps on hospital discharge report; 2.) increased involvement of general practitioners; 3.) exact timing and raising awareness of follow-up examinations; 4.) accurate planning of laboratory controls; 5.) the better patient education. In order to improve long-term cardiovascular morbidity and mortality, it would be important for all colleagues who are is involved in the management of patients with acute coronary syndrome, such as discharging cardiologists, caregiver specialists and general practitioners to routinely apply recommendations listed in this article. In this practice trained nurses could be involved as well, in addition the optimalisation of lipid lowering treatment is a therapeutic area too, where the advantage of telemedicine should be applied.

The expanding needs on lipid-lowering treatment in patients with acute coronary syndrome by applying newly issued definition of extreme high-risk by Chinese Society of Cardiology

Objective: To assess the expanding needs on lipid-lowering treatment in patients with acute coronary syndrome (ACS) by applying newly issued definition of extreme high-risk, which is proposed by Chinese expert consensus on lipid management of extreme high-risk atherosclerotic cardiovascular disease (ASCVD) patients of Chinese Society of Cardiology (CSC). Methods: Data of this study was derived from the Improving Care for Cardiovascular Disease in China (CCC) project, which was a case-based nationwide registry study and launched as a collaborative initiative by the American Heart Association and the CSC. The project consecutively recruited ACS patients from158 tertiary hospitals and 82 second hospitals across China, and detailed clinical information of patients was collected. This study enrolled ACS inpatients in CCC project from November 2014 to July 2019. The proportion of extreme high-risk patients, their characteristics, mean LDL-C levels at admission, the gap between measured LDL-C level and the new target, and lipid-lowering therapy at discharge were assessed. Results: Among 104 516 ACS inpatients enrolled in this study, 75.1% (78 527/104 516) met the criteria of extreme high-risk and were expected to achieve the new LDL-C goal. Among patients at extreme high-risk, 21.2% (16 651/78 527) had multiple severe ASCVD events and 78.8% (61 876/78 527) had 1 severe ASCVD event and at least two high-risk factors. For the extreme high-risk patients, the mean level of LDL-C at admission was (2.8±1.0) mmol/L, prevalence of LDL-C ≥1.4 mmol/L was 93.4% (73 307/78 527) and the median gap between LDL-C level at admission and the target of 1.4 mmol/L was 1.3 (0.8, 2.0) mmol/L. If LDL-C could be further reduced to 50% of the admission level, we estimated that 55.6% (43 632/78 527) of the extreme high-risk patients would achieve the new LDL-C goal. Among 40 875 patients with information about discharge statin dosage, 93.5% (28 004/29 947) of the extreme high-risk patients were prescribed with statins at discharge, and among them 95.1% (26 632/28 004) received statin monotherapy and 91.1% (25 501/28 004) were at moderate doses of statins. Conclusion: About three fourth of inpatients with ACS were categorized as extreme high-risk based on the new definition of CSC expert consensuses, nine out of ten patients at extreme high-risk didn't achieve the new LDL-C target at admission, and the intensity of lipid-lowering therapy was insufficient in clinical practice. There are substantially expanding needs for implementing more intensive and effective lipid-lowering strategies.

Lipid-lowering nutraceuticals update on scientific evidence.

: Cardiovascular diseases (CVDs) are the main cause of mortality worldwide. Risk factors of CVD can be classified into modifiable (smoking, hypertension, diabetes, hypercholesterolemia) through lifestyle changes or taking drug therapy and not modifiable (age, ethnicity, sex and family history). Elevated total cholesterol (TC) and low-density lipoprotein-cholesterol (LDL-C) levels have a lead role in the development of coronary heart disease (CHD), while high levels of high-density lipoprotein-cholesterol (HDL-C) seem to have a protective role.The current treatment for dyslipidemia consists of lifestyle modification or drug therapy even if not pharmacological treatment should be always considered in addition to lipid-lowering medications.The use of lipid-lowering nutraceuticals alone or in association with drug therapy may be considered when the atherogenic cholesterol goal was not achieved.These substances can be classified according to their mechanisms of action into natural inhibitors of intestinal cholesterol absorption, inhibitors of hepatic cholesterol synthesis and enhancers of the excretion of LDL-C. Nevertheless, many of them are characterized by mixed or unclear mechanisms of action.The use of these nutraceuticals is suggested in individuals with borderline lipid profile levels or with drug intolerance, but cannot replace standard lipid-lowering treatment in patients at high, or very high CVD risk.Nutraceuticals can also have vascular effects, including improvement in endothelial dysfunction and arterial stiffness, as well as antioxidative properties. Moreover, epidemiological and clinical studies reported that in patients intolerant of statins, many nutraceuticals with demonstrated hypolipidemic effect are well tolerated.

Clinical characteristics and lipid lowering treatment of patients initiated on proprotein convertase subtilisin-kexin type 9 inhibitors: a nationwide cohort study

ObjectivesGiven the novelty of proprotein convertase subtilisin-kexin type 9 inhibitors (PCSK9i), little is known regarding overall implementation or clinical characteristics among patients who initiate treatment. We aimed to assess the...

Determinants of inertia with lipid-lowering treatment in patients with type 2 diabetes mellitus

ObjectiveTo assess the control of cLDL in diabetic patients, to measure the impact on such control of inertia with lipid-lowering agents and to explore factors that allow for predicting this inertia. MethodsStudy of historical cohorts of diabetic patients. The proportion of patients who achieved the target cLDL levels was estimated. Therapeutic inertia was considered when the dose of the lipid-lowering agents was not adjusted, or a lipid-lowering agent was not changed or added in patients with initial cLDL outside the target. Change in cLDL from the first to the last visit and inertia with lipid-lowering drugs were analyzed according to comorbidities, cardiovascular risk factors and treatments used. ResultsThe study simple consisted of 639 patients (mean follow-up time 11.1±11.2 months), of whom 27.5% achieved target cLDL levels. Inertia occurred in 43.6% of patients with initial cLDL outside the target. Independent predictors of inertia were the initial cLDL (p<0.001), polyneuropathy (p=0.014), adjustment of antihypertensive agents (p=0.002), adequacy of lipid-lowering agents (p<0.001), use of ezetimibe (p=0.001) and adherence to lipid-lowering drugs (p=0.015). ConclusionsInertia with lipid-lowering agents in a diabetic patient is less frequent in the presence of higher cLDL values, in cases of polyneuropathy, when antihypertensive agents are adjusted or changed, and when non-adherence is detected. The adequate initial prescription of statins and the association with ezetimibe decrease the likelihood of committing inertia.