Guanmin Chen MD PhD MPH Senior Biostatistician Research Facilitation, Alberta Health Services Adjunct Research Assistant Professor University of Calgary

Lipid Control Treatment Gap in Patients with Atherosclerotic Disease Interview with:

Guanmin Chen MD PhD MPH Senior Biostatistician Research Facilitation, Alberta Health Services Adjunct Research Assistant Professor University of Calgary

Dr. Chen

Guanmin Chen MD PhD MPH
Senior Biostatistician Research Facilitation, Alberta Health Services
Adjunct Research Assistant Professor
University of Calgary 

Co-authors: Guanmin Chen, PhD, MD, MPH, Megan S. Farris, MSc, Tara Cowling, MA, MSc, Stephen M. Colgan, PhD, Pin Xiang, PharmD, Louisa Pericleous, PhD, Raina M. Rogoza, MSc, Ming-Hui Tai, MSc, PhD, and Todd Anderson, MD What are the main findings?


  • Atherosclerotic cardiovascular disease (ASCVD) remains a significant cause of morbidity and mortality in Canada (and worldwide). Despite the established benefits of treatment with statins, most Canadians fail to achieve dyslipidemia targets (a risk factor for ASCVD).
  • The objective of this study was to examine current treatment patterns of lipid-lowering therapies for the management of low-density lipoprotein cholesterol (LDL-C) in patients with ASCVD.
  • This was a retrospective cohort study conducted using province-wide administrative health data from Alberta, Canada. Datasets used included health services, pharmaceutical, and laboratory data, in addition to the Alberta population registry. The study population consisted of individuals aged 18 years or older diagnosed with ASCVD between 2011-2015, based on International Classification of Diseases (ICD) codes. The cohort was then restricted to individuals with an initial (index) LDL-C measurement after ASCVD diagnosis and at least one year of pre-index data and one year of follow-up data. What are the main findings?

Response: This study identified 281,665 patients with ASCVD in Alberta during the study years, of which, 78% had an index LDL-C measurement. Among these patients, only 66% received lipid-lowering therapies following their index LDL-C measurement. In patients with a follow-up LDL-C test, approximately 37% of patients did not achieve threshold LDL-C levels (<2 mmol/L or a >50% reduction), despite most patients being adherent to their treatment (as defined by taking at least 80% of medication). What should readers take away from your report?

Response: The results of this study highlight a substantial treatment gap in patients with ASCVD in Alberta, with an approximately equal distribution of one third of patients untreated, one third of patients who were treated, but failed to achieve their LDL-C threshold levels, and one third of patients who were treated and attained threshold LDL-C levels. What recommendations do you have for future research as a result of this work?

Response: Additional research is necessary to assess the effects of the identified treatment gap on morbidity, mortality and other important outcomes, such as health related quality of life, functional status as well as healthcare societal costs. In addition, determining the reasons behind the identified treatment gap would aid in the development of sustainable strategies to improve the management and delivery of care for patients with ASCVD. 

Disclosures: Funding Sources: This work was supported by Amgen Inc. (Amgen), Thousand Oaks, California, United States of America. Amgen collaborated with Medlior Health Outcomes Research Ltd (Medlior) in the study design of the project. Medlior was responsible for requesting, analyzing and reporting of data.

Disclosures: Guanmin Chen is a consultant for Medlior. He has also received research funding from the Canadian Institutes for Health Research. Megan S. Farris and Tara Cowling are employed by Medlior. Pin Xiang, Ming-Hui Tai, Stephan Colgan, Louisa Pericleous and Raina Rogoza are employed by Amgen and hold Amgen stock. Todd Anderson received research funding from Amgen, Merck and Dal-cor for being a local Principal Investigator for randomized clinical trials. He also has received speaker fees from Sanofi, Amgen and Bayer.



Guanmin Chen, Megan S. Farris, Tara Cowling, Stephen M. Colgan, Pin Xiang, Louisa Pericleous, Raina M. Rogoza, Ming-Hui Tai, Todd Anderson. Treatment and Low-Density Lipoprotein Cholesterol Management in Patients Diagnosed With Clinical Atherosclerotic Cardiovascular Disease in Alberta. Canadian Journal of Cardiology, 2019; 35 (7): 884 DOI: 10.1016/j.cjca.2019.04.008 

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Last Updated on July 18, 2019 by Marie Benz MD FAAD