Please use this identifier to cite or link to this item: http://hdl.handle.net/2381/40418
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dc.contributor.authorDanese, Mark D.-
dc.contributor.authorGleeson, Michelle-
dc.contributor.authorKutikova, Lucie-
dc.contributor.authorGriffiths, Robert I.-
dc.contributor.authorKhunti, Kamlesh-
dc.contributor.authorSeshasai, Sreenivasa Rao Kondapally-
dc.contributor.authorRay, Kausik K.-
dc.date.accessioned2017-10-03T10:49:18Z-
dc.date.available2017-10-03T10:49:18Z-
dc.date.issued2017-05-01-
dc.identifier.citationBMJ Open, 2017, 7 (5), e013851en
dc.identifier.urihttp://bmjopen.bmj.com/content/7/5/e013851.infoen
dc.identifier.urihttp://hdl.handle.net/2381/40418-
dc.description.abstractOBJECTIVES: To describe low-density lipoprotein (LDL) cholesterol management and lipid-lowering treatment patterns in patients with a cardiovascular (CV) event. DESIGN: Retrospective cohort study using Clinical Practice Research Datalink records linked with Hospital Episode Statistics data. SETTING: Routine clinical practice in the UK from 2006 to 2012. PARTICIPANTS: Individuals ≥18 years were selected at their first CV-related hospitalisation (first event cohort) if they had received ≥2 lipid-lowering therapy prescriptions within 180 days beforehand. Patients were stratified into four mutually exclusive subgroups based on the presence or absence of vascular disease and of diabetes. Those with a second CV hospitalisation within 36 months were included in a separate cohort (second event cohort). PRIMARY AND SECONDARY OUTCOME MEASURES: LDL levels in the year prior to the CV event and 12 months later as well as measures of adherence to lipid-lowering therapy during the 12 months after the CV hospitalisation. RESULTS: There were 24 093 patients in the first event cohort, of whom 5274 were included in the second event cohort. Most received moderate intensity statins at baseline and 12 months. Among the four first event cohort subgroups at baseline, the proportions with an LDL of <1.8 mmol/L was similar between the two diabetic cohorts (36% to 38%) and were higher than those in the two non-diabetic cohorts (17% to 22%) and in the second event cohort (31%). An incremental 5% to 9% had an LDL below 1.8 mmol/L at 12 months, suggesting intensification of therapy. The proportion of adherent patients (medication possession ratio of≥0.8) was highest for statins, ranging from 68% to 72%. For ezetimibe, the range was 65% to 70%, and for fibrates, it was 48% to 62%. CONCLUSIONS: Despite the existence of effective therapies for lowering cholesterol, patients do not reach achievable LDL targets.en
dc.language.isoenen
dc.publisherBMJ Publishing Groupen
dc.relation.urihttps://www.ncbi.nlm.nih.gov/pubmed/28495810-
dc.rightsCopyright © the authors, 2017. This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-commercial License (https://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted use, distribution, and reproduction in any medium non-commercially, provided the original author and source are credited.en
dc.subjectcardiovascular diseaseen
dc.subjectlow density lipoproteinen
dc.subjecttreatment adherenceen
dc.titleManagement of lipid-lowering therapy in patients with cardiovascular events in the UK: a retrospective cohort studyen
dc.typeJournal Articleen
dc.identifier.doi10.1136/bmjopen-2016-013851-
dc.identifier.eissn2044-6055-
dc.identifier.piibmjopen-2016-013851-
dc.description.statusPeer-revieweden
dc.description.versionPublisher Versionen
dc.type.subtypeJournal Article-
pubs.organisational-group/Organisationen
pubs.organisational-group/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGYen
pubs.organisational-group/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicineen
pubs.organisational-group/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/School of Medicine/Department of Health Sciencesen
pubs.organisational-group/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/Themesen
pubs.organisational-group/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/Themes/Cardiovascularen
pubs.organisational-group/Organisation/COLLEGE OF MEDICINE, BIOLOGICAL SCIENCES AND PSYCHOLOGY/Themes/Populationen
dc.dateaccepted2017-03-08-
Appears in Collections:Published Articles, Dept. of Health Sciences

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