Concordance to Guideline-recommended Statin Therapy: Real-world Evidence from India

Surendra Shamkant Borgharkar; Soma Soumitra Das

doi:doi:10.11648/j.ajhr.20200803.11

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Concordance to Guideline-recommended Statin Therapy: Real-world Evidence from India

Surendra Shamkant Borgharkar, Soma Soumitra Das

Published in American Journal of Health Research (Volume 8, Issue 3)

Received: 13 April 2020 Accepted: 30 April 2020 Published: 28 May 2020

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Abstract

To evaluate concordance to the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline on treatment of blood cholesterol for primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD) in India. Concordance to 2013 ACC/AHA guideline was assessed by retrospectively analyzing statin therapy prescribing practice as per ASCVD risk score in four statin-benefit groups in 23,295 patients aged 40-79 years from health facilities across India between 2017 and 2018. Mean (±SD) age of patients was 58.9 (±9.2) years; 62% were men; 60% (n=14,070) had clinical ASCVD. Among patients without ASCVD (n=7,122), 3.9% (n=278) had low-density lipoprotein-cholesterol (LDL-C) ≥190 mg/dL, 94.0% (n=6,694) had diabetes mellitus and 2.1% (n=150) patients had 10-year ASCVD risk ≥7.5%. Among 18,795 patients (81%) eligible for high-intensity statins, only 34% were concordant whereas 63% were treated with moderate-intensity statins. Among 2,290 patients eligible for moderate-intensity statins, 76% were concordant and 18% received high-intensity statins. Among patients with ASCVD (<75 years), 43% received high-intensity statins, 55% received moderate-intensity statins, while 2% did not receive statins. Among patients with diabetes and ASCVD risk <7.5%, 86% received moderate-intensity statins, but those with risk >7.5%, 83% remained under-treated. Most patients (82%) with LDL-C >190 mg/dL were prescribed with moderate-intensity statins. Most patients were receiving statins at dose non-concordant to 2013 ACC/AHA guideline, reflecting gaps in real-world practice of prescribing statins for primary and secondary prevention of ASCVD. Addressing care gaps and promoting compliance to optimize statin therapy will help reduce cardiovascular disease, especially in high-risk population among South Asians.

Published in	American Journal of Health Research (Volume 8, Issue 3)
DOI	10.11648/j.ajhr.20200803.11
Page(s)	18-25
Creative Commons	This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.
Copyright	Copyright © The Author(s), 2020. Published by Science Publishing Group

Keywords

Cardiovascular Disease, Statin Therapy, Real-world Evidence, Low-density Lipoprotein-Cholesterol, Cholesterol Guidelines

References

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APA Style

Surendra Shamkant Borgharkar, Soma Soumitra Das. (2020). Concordance to Guideline-recommended Statin Therapy: Real-world Evidence from India. American Journal of Health Research, 8(3), 18-25. https://doi.org/10.11648/j.ajhr.20200803.11

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ACS Style

Surendra Shamkant Borgharkar; Soma Soumitra Das. Concordance to Guideline-recommended Statin Therapy: Real-world Evidence from India. Am. J. Health Res. 2020, 8(3), 18-25. doi: 10.11648/j.ajhr.20200803.11

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AMA Style

Surendra Shamkant Borgharkar, Soma Soumitra Das. Concordance to Guideline-recommended Statin Therapy: Real-world Evidence from India. Am J Health Res. 2020;8(3):18-25. doi: 10.11648/j.ajhr.20200803.11

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@article{10.11648/j.ajhr.20200803.11,
  author = {Surendra Shamkant Borgharkar and Soma Soumitra Das},
  title = {Concordance to Guideline-recommended Statin Therapy: Real-world Evidence from India},
  journal = {American Journal of Health Research},
  volume = {8},
  number = {3},
  pages = {18-25},
  doi = {10.11648/j.ajhr.20200803.11},
  url = {https://doi.org/10.11648/j.ajhr.20200803.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajhr.20200803.11},
  abstract = {To evaluate concordance to the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline on treatment of blood cholesterol for primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD) in India. Concordance to 2013 ACC/AHA guideline was assessed by retrospectively analyzing statin therapy prescribing practice as per ASCVD risk score in four statin-benefit groups in 23,295 patients aged 40-79 years from health facilities across India between 2017 and 2018. Mean (±SD) age of patients was 58.9 (±9.2) years; 62% were men; 60% (n=14,070) had clinical ASCVD. Among patients without ASCVD (n=7,122), 3.9% (n=278) had low-density lipoprotein-cholesterol (LDL-C) ≥190 mg/dL, 94.0% (n=6,694) had diabetes mellitus and 2.1% (n=150) patients had 10-year ASCVD risk ≥7.5%. Among 18,795 patients (81%) eligible for high-intensity statins, only 34% were concordant whereas 63% were treated with moderate-intensity statins. Among 2,290 patients eligible for moderate-intensity statins, 76% were concordant and 18% received high-intensity statins. Among patients with ASCVD (7.5%, 83% remained under-treated. Most patients (82%) with LDL-C >190 mg/dL were prescribed with moderate-intensity statins. Most patients were receiving statins at dose non-concordant to 2013 ACC/AHA guideline, reflecting gaps in real-world practice of prescribing statins for primary and secondary prevention of ASCVD. Addressing care gaps and promoting compliance to optimize statin therapy will help reduce cardiovascular disease, especially in high-risk population among South Asians.},
 year = {2020}
}

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TY  - JOUR
T1  - Concordance to Guideline-recommended Statin Therapy: Real-world Evidence from India
AU  - Surendra Shamkant Borgharkar
AU  - Soma Soumitra Das
Y1  - 2020/05/28
PY  - 2020
N1  - https://doi.org/10.11648/j.ajhr.20200803.11
DO  - 10.11648/j.ajhr.20200803.11
T2  - American Journal of Health Research
JF  - American Journal of Health Research
JO  - American Journal of Health Research
SP  - 18
EP  - 25
PB  - Science Publishing Group
SN  - 2330-8796
UR  - https://doi.org/10.11648/j.ajhr.20200803.11
AB  - To evaluate concordance to the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline on treatment of blood cholesterol for primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD) in India. Concordance to 2013 ACC/AHA guideline was assessed by retrospectively analyzing statin therapy prescribing practice as per ASCVD risk score in four statin-benefit groups in 23,295 patients aged 40-79 years from health facilities across India between 2017 and 2018. Mean (±SD) age of patients was 58.9 (±9.2) years; 62% were men; 60% (n=14,070) had clinical ASCVD. Among patients without ASCVD (n=7,122), 3.9% (n=278) had low-density lipoprotein-cholesterol (LDL-C) ≥190 mg/dL, 94.0% (n=6,694) had diabetes mellitus and 2.1% (n=150) patients had 10-year ASCVD risk ≥7.5%. Among 18,795 patients (81%) eligible for high-intensity statins, only 34% were concordant whereas 63% were treated with moderate-intensity statins. Among 2,290 patients eligible for moderate-intensity statins, 76% were concordant and 18% received high-intensity statins. Among patients with ASCVD (7.5%, 83% remained under-treated. Most patients (82%) with LDL-C >190 mg/dL were prescribed with moderate-intensity statins. Most patients were receiving statins at dose non-concordant to 2013 ACC/AHA guideline, reflecting gaps in real-world practice of prescribing statins for primary and secondary prevention of ASCVD. Addressing care gaps and promoting compliance to optimize statin therapy will help reduce cardiovascular disease, especially in high-risk population among South Asians.
VL  - 8
IS  - 3
ER  -

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Author Information

Surendra Shamkant Borgharkar

Sun Pharmaceutical Industries Ltd., Mumbai, India
Soma Soumitra Das

Covance Scientific Services & Solutions Pvt. Ltd., Pune, India

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APA Style

Surendra Shamkant Borgharkar, Soma Soumitra Das. (2020). Concordance to Guideline-recommended Statin Therapy: Real-world Evidence from India. American Journal of Health Research, 8(3), 18-25. https://doi.org/10.11648/j.ajhr.20200803.11

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ACS Style

Surendra Shamkant Borgharkar; Soma Soumitra Das. Concordance to Guideline-recommended Statin Therapy: Real-world Evidence from India. Am. J. Health Res. 2020, 8(3), 18-25. doi: 10.11648/j.ajhr.20200803.11

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AMA Style

Surendra Shamkant Borgharkar, Soma Soumitra Das. Concordance to Guideline-recommended Statin Therapy: Real-world Evidence from India. Am J Health Res. 2020;8(3):18-25. doi: 10.11648/j.ajhr.20200803.11

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@article{10.11648/j.ajhr.20200803.11,
  author = {Surendra Shamkant Borgharkar and Soma Soumitra Das},
  title = {Concordance to Guideline-recommended Statin Therapy: Real-world Evidence from India},
  journal = {American Journal of Health Research},
  volume = {8},
  number = {3},
  pages = {18-25},
  doi = {10.11648/j.ajhr.20200803.11},
  url = {https://doi.org/10.11648/j.ajhr.20200803.11},
  eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajhr.20200803.11},
  abstract = {To evaluate concordance to the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline on treatment of blood cholesterol for primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD) in India. Concordance to 2013 ACC/AHA guideline was assessed by retrospectively analyzing statin therapy prescribing practice as per ASCVD risk score in four statin-benefit groups in 23,295 patients aged 40-79 years from health facilities across India between 2017 and 2018. Mean (±SD) age of patients was 58.9 (±9.2) years; 62% were men; 60% (n=14,070) had clinical ASCVD. Among patients without ASCVD (n=7,122), 3.9% (n=278) had low-density lipoprotein-cholesterol (LDL-C) ≥190 mg/dL, 94.0% (n=6,694) had diabetes mellitus and 2.1% (n=150) patients had 10-year ASCVD risk ≥7.5%. Among 18,795 patients (81%) eligible for high-intensity statins, only 34% were concordant whereas 63% were treated with moderate-intensity statins. Among 2,290 patients eligible for moderate-intensity statins, 76% were concordant and 18% received high-intensity statins. Among patients with ASCVD (7.5%, 83% remained under-treated. Most patients (82%) with LDL-C >190 mg/dL were prescribed with moderate-intensity statins. Most patients were receiving statins at dose non-concordant to 2013 ACC/AHA guideline, reflecting gaps in real-world practice of prescribing statins for primary and secondary prevention of ASCVD. Addressing care gaps and promoting compliance to optimize statin therapy will help reduce cardiovascular disease, especially in high-risk population among South Asians.},
 year = {2020}
}

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TY  - JOUR
T1  - Concordance to Guideline-recommended Statin Therapy: Real-world Evidence from India
AU  - Surendra Shamkant Borgharkar
AU  - Soma Soumitra Das
Y1  - 2020/05/28
PY  - 2020
N1  - https://doi.org/10.11648/j.ajhr.20200803.11
DO  - 10.11648/j.ajhr.20200803.11
T2  - American Journal of Health Research
JF  - American Journal of Health Research
JO  - American Journal of Health Research
SP  - 18
EP  - 25
PB  - Science Publishing Group
SN  - 2330-8796
UR  - https://doi.org/10.11648/j.ajhr.20200803.11
AB  - To evaluate concordance to the 2013 American College of Cardiology/American Heart Association (ACC/AHA) guideline on treatment of blood cholesterol for primary and secondary prevention of atherosclerotic cardiovascular disease (ASCVD) in India. Concordance to 2013 ACC/AHA guideline was assessed by retrospectively analyzing statin therapy prescribing practice as per ASCVD risk score in four statin-benefit groups in 23,295 patients aged 40-79 years from health facilities across India between 2017 and 2018. Mean (±SD) age of patients was 58.9 (±9.2) years; 62% were men; 60% (n=14,070) had clinical ASCVD. Among patients without ASCVD (n=7,122), 3.9% (n=278) had low-density lipoprotein-cholesterol (LDL-C) ≥190 mg/dL, 94.0% (n=6,694) had diabetes mellitus and 2.1% (n=150) patients had 10-year ASCVD risk ≥7.5%. Among 18,795 patients (81%) eligible for high-intensity statins, only 34% were concordant whereas 63% were treated with moderate-intensity statins. Among 2,290 patients eligible for moderate-intensity statins, 76% were concordant and 18% received high-intensity statins. Among patients with ASCVD (7.5%, 83% remained under-treated. Most patients (82%) with LDL-C >190 mg/dL were prescribed with moderate-intensity statins. Most patients were receiving statins at dose non-concordant to 2013 ACC/AHA guideline, reflecting gaps in real-world practice of prescribing statins for primary and secondary prevention of ASCVD. Addressing care gaps and promoting compliance to optimize statin therapy will help reduce cardiovascular disease, especially in high-risk population among South Asians.
VL  - 8
IS  - 3
ER  -

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